In most cases the manifestation codes will have in the code title, "in diseases. These items provide guidelines for using the code set. In most cases, the manifestation codes will have in the code title “in diseases classified elsewhere. Instructional notes indicate the proper sequencing order of these conditions-etiology (underlying condition) followed by manifestation. 8, B96. Code Also –A “code also” note instructs that two codes may be required to fully describe a condition, but the sequencing of the two codes depends on the severity of the conditions and the reason for the encounter. An instructional note for Chapter 1 where B95. The point dash appears to signal to the coder that _____. Wherever such a combination exists, there is a "use additional code" note at the etiology code, and a "code first" note at the manifestation code. These are sequencing instructions that must be followed. The notes also remind the code to use an additional (secondary) code to show the dialysis status (Z99. - or I51. Wherever such a combination exists there is a "use additional code" note at the etiology code, and a "code first" note at the manifestation code. Wherever such a combination exists, there is a “use additional code” note at the etiology code and a “code first” note at the manifestation code. 9. R14. 0. 89 (other post-procedural complications and disorders of the circulatory system, not elsewhere classified) and I48. The includes note is used to define, give examples, or both, of the content of a category of ICD-10-CM or of a block of category codes. 890 is exempt from POA reporting ( Present On Admission). In the tabular, code G31. F10. Tuberculous erythema nodosum is coded to L52. This is addressed in guideline 1. 22)” applies to. followed by the manifestation. 1-N18. use additional code for any associated physical or developmental disorders. The additions. In addition,. This indicates the sequencing. It is found in the 2024 version of the ICD-10 Clinical Modification (CM) and can be used in all HIPAA-covered transactions from Oct 01, 2023 - Sep 30, 2024 . If a code. 1. 0 is a valid billable ICD-10 diagnosis code for Dehydration . Category P00 Code first note and excludes2 note 1. Make sure to review pairs of ‘Use additional code’ notes at the etiology code, and ‘Code first’ notes at the manifestation code to ensure proper sequencing order in the guidance,” Blanchard adds. 4-)Study with Quizlet and memorize flashcards containing terms like These _____ are incorporated within the Alphabetic Index and Tabular List of the ICD--CM as instructional notes, The conventions and instructions of the classification take precedence over _____, The _____ _____ is an alphabetical list of terms and their corresponding code. Additional Instructional Notes Excludes -1 Under a three digit category code, an Excludes 1 designation means that the code is NOT CODED HERE and indicates that two codes are mutually exclusive and therefore cannot be coded as separate codes in same encounter (example E66). 3. The diagnosis codes (Volumes 1-2) have been adopted under HIPAA for all healthcare settings. Introduction to ICD-10-CM. These instructional notes indicate the proper sequencing order of the codes, etiology followed by manifestation. These instructional notes indicate the proper sequencing order of the codes, etiology followed by manifestation. Wherever an etiology and manifestation combination of codes exists, the manifestation code contains an instructional note to: use of an additional code. Some categories of codes (e. A “code also” note alerts the coder that more than. True B. c. ↓ See below for any exclusions, inclusions or special notations. -) Use additional code to identify stage of chronic kidney disease ( N18. ICD-10-CM codes would be I97. When using code E66. ↓ See below for any exclusions, inclusions or special notations. On the etiology side, the etiology/manifestation combination is signaled by the instructional note “use additional code,” present at the level of the category. Wherever such a combination exists there is a "use additional code" note at the etiology code, and a "code first" note at the manifestation code. The 7 th character must always be the 7 th character in the data field. A list of abbreviations, punctuation, symbols, typefaces, and instructional notes appears at the beginning of the ICD-9-CM. When it applies, codes missing this character are. It is found in the 2024 version of the ICD-10 Clinical Modification (CM) and can be used in all HIPAA-covered transactions from Oct 01, 2023 - Sep 30, 2024 . ↓ See below for any exclusions, inclusions or special notations. xxxx Drug or chemical-induced diabetes mellitus Code first a dx from (T36-T65) Use additional code for adverse effect (T36-T50) E10. ) Courtesy of the Centers for Medicare & Medicaid Services, 3-1d See Also Instructional Note Another cross-reference note used in ICD-10-CM, the See Also note refers the coder to another location in the Alphabetic Index when the initial listing does not contain all the. instructional notes. A “code first underlying disease” instructional note will appear with the. It is found in the 2024 version of the ICD-10 Clinical Modification (CM) and can be used in all HIPAA-covered transactions from Oct 01, 2023 - Sep 30, 2024 . 6). [Brackets] are an ICD-10-CM convention indicating the enclosed code is. Watch the instructional notes carefully. The “Use additional” code note is found below the underlying condition code. In addition,. These instructional notes indicate the proper sequencing order of the codes, etiology followed by manifestation. N30. It is used in the alphabetical Index of ICD-10-CM and instructs the coder that another term should be referenced. Manifestation code = “code 1st” These instructional notes indicate the proper sequencing order of the codes 3. In ICD coding, the code first is not used. Wherever such a combination exists there is a "use additional code" note at the etiology code, and a "code first" note at the manifestation code. includes notation C. Z71. The additional code referenced with the “see” note to locate the correct code. The Includes note is used to define, give examples, or both, of the content of a category. These instructional notes indicate the proper sequencing order of the codes, etiology followed by manifestation. N18. Wherever such a combination exists there is a "use additional code" note at the etiology code, and a "code first" note at the manifestation code. It is found in the 2024 version of the ICD-10 Clinical Modification (CM) and can be used in all HIPAA-covered transactions from Oct 01, 2023 - Sep 30, 2024 . [Brackets] are an ICD-10-CM convention indicating the enclosed code is a manifestation code INSTRUCTIONAL NOTES Excludes1&2 Tip: Excludes1: Only 1 code can be used Excludes2: 2 codes can be use if both are appropriate and there is proper documentation for both 11/19/2015 17 INSTRUCTIONAL NOTES • “Code First” & “Use Additional Code” • Used for Sequencing Priority – Found in Tabular Use of "Code also" or "Use Additional code" Instructions in ICD 10 coding for medical coders. INSTRUCTIONAL NOTES Excludes1&2 Tip: Excludes1: Only 1 code can be used Excludes2: 2 codes can be use if both are appropriate and there is proper documentation for both 11/19/2015 17 INSTRUCTIONAL NOTES • “Code First” & “Use Additional Code” • Used for Sequencing Priority – Found in TabularUse of "Code also" or "Use Additional code" Instructions in ICD 10 coding for medical coders. ) Assign multiple codes when required (usually coder will be guided to do this by additional instructional notes in the ICD-9. 890. 2. Code First. 44 (Sepsis following a procedure). In most cases the manifestation codes will have in the code title, "in diseases. An instructional note in ICD-10-CM for intellectual disabilities (F70 through F79) directs coders to: a. ↓ See below for any exclusions,. provide general information on usage in a specific section. 5. Instructional Notes. The "use additional code" note is. J06. Thromboarteritis - see arteritis. 32 is a valid billable ICD-10 diagnosis code for Chronic kidney disease, stage 3b . This convention instructs you to “Code first” the underlying condition, followed by etiology and/or manifestations. The "use additional code" note will be found under the associated condition code in the "Tabular List of Diseases. It is found in the 2024 version of the ICD-10 Clinical Modification (CM) and can be used in all HIPAA-covered transactions from Oct 01, 2023 - Sep 30, 2024 . Use additional code to indicate outcome of delivery Z37. Group of answer choices. Question 1. These instructional notes indicate the proper sequencing order of the codes, etiology followed by manifestation. Code H27. When it applies, codes missing this character are. Wherever such a combination exists there is a "use additional code" note at the etiology code, and a "code first" note at the manifestation code. C. Wherever such a combination exists there is a "Use Additional Code" note at the etiology code, and a "Code First" note at the manifestation code. Breakdown the ICD-10-CM Guidelines. These instructional notes indicate the proper sequencing order of the codes, etiology followed by manifestation. Wherever such a combination exists, there is a “use additional code” note at the etiology code, and a “code first” note at the manifestation code. In practice our coders apply this convention only when the infectious agent is known. At the beginning of Chapter 15 there is a note to use an additional code from Category Z3A Weeks of gestation, to identify the weeks of gestation for codes O00-O9A. It is found in the 2024 version of the ICD-10 Clinical Modification (CM) and can be used in all HIPAA-covered transactions from Oct 01, 2023 - Sep 30, 2024 . These instructional notes indicate the proper sequencing order of the codes, etiology followed by manifestation. A. ” 1. the note represents "not included here. You will also find instructional notes that say code first or use additional code. Similar to ICD-9-CM, "Code first" and "Use additional code" notes are present for some of the diabetes mellitus categories and subcategories that require the underlying condition be sequenced first, followed by the manifestation. What is the ICD-10-CM code for nausea? R11. "Code, if applicable, any causal condition first" note OD. the mainifestaion code will have a "code first" instructional note, and the eitiology code will have a " use additonal code" note in the tabular list. Use the primary code and change the number of units to match the number of biopsies taken Use the appropriate add-on code for a different technique Use the appropriate add-on code for the appropriate technique Use the primary code and only bill one unitE66. Use additional code, where applicable, to identify: history of tobacco dependence (Z87. What is the ICD-10-CM code for hay fever?Wherever such a combination exists, there is a “use additional code” note at the etiology code, and a “code first” note at the manifestation code. -)It is important to use both the Alphabetic Index and the Tabular list when assigning ICD-10-CM codes because we do not code from the Alphabetic Index, the alphabetic index doesn’t provide the full code and you must refer to the Tabular List to get the full code 2 how instructional notes in both the Alphabetic Index and the Tabular List guide. These instructional notes indicate the proper sequencing order of the codes, etiology followed by manifestation. These instructional notes indicate the proper sequencing order of the codes, etiology followed by manifestation. Use additional code to identify type of heart failure (I50. It is found in the 2024 version of the ICD-10 Clinical Modification (CM) and can be used in all HIPAA-covered transactions from Oct 01, 2023 - Sep 30, 2024 . The “code first” note is an instructional note. ↓ See below for any exclusions, inclusions or special notations. 1R29. An instructional note in ICD-10-CM for intellectual disabilities (F70 through F79) directs coders to: a. Example. Wherever such a combination exists, there is a “use additional code” note at the etiology code, and a “code first” note at the manifestation code. Code N18. 0 indicates to use additional code to identify the stage of the CKD. The diagnosis codes (Tabular List and Alphabetic Index) have been adopted under HIPAA for all healthcare settings. 3 is a valid billable ICD-10 diagnosis code for Dietary counseling and surveillance . C. These instructional notes indicate that the etiology code should be listed first followed by the manifestation code. These instructional notes indicate the proper. • Read and follow instructions • Includes & Exclude notes • Use additional code • Code first underlying disease • Code also • Character requirements – 4th, 5th, 6th, & 7th • Age and gender 6 . Wherever such a combination exists there is a "use additional code" note at the etiology code, and a "code first" note at the manifestation code. It is found in the 2024 version of the ICD-10 Clinical Modification (CM) and can be used in all HIPAA-covered transactions from Oct 01, 2023 - Sep 30, 2024 . Wherever such a combination exists, a Use additional code note is found with the etiology code, and a Code first note is found with the manifestation code. The patient is also a type 1 diabetic with diabetic retinopathy and diabetic neuropathy. Explain two (2) methods you will use to build good coding habits. - Codes also specify the _____ of vessels to identify the specific location of disease. Correctly use instructional terms and symbols as defined in the ICD-9-CM. 4-I51. Assign code V12. Wherever such a combination exists, there is a “use additional code” note at the etiology code, and a “code first” note at the manifestation code. They may appear independently of each other or to designate certain etiology/manifestation paired codes. Codes with this phrase are never used as a first-listed or principal diagnosis. The SEE ALSO instructional note. F33. ”Verified questions. 22)” applies to All codes in ICD-10-CM Chapter 10. detail to ensure the code assignment is not affected. 9 is a valid billable ICD-10 diagnosis code for Acute upper respiratory infection, unspecified . "Code first" notes are also under certain codes that are not specifically manifestation codes but may be due to an underlying cause. 4 , N18. Selected Answer : The code should be sequenced first . These instructional notes indicate the proper sequencing order of the codes, etiology followed by manifestation. However, if the coder also sees the instructional note of "Use an Additional Code" in the ICD 10 CM Code Book in the Tabular List, the coder would then also provide an additional code to provide. These instructional notes indicate the proper sequencing order of the codes, etiology followed by manifestation. Wherever such a combination exists there is a 'use additional code' note at the etiology code, and a 'code first' note at the manifestation code. Patient present with anemia and is admitted for transfusion. Excludes 1: fever and chills. which may or may not be followed by the ICD-9-CM code number, nonessential modifiers, or followed by Instructional Notes. These instructional notes indicate the proper sequencing order of the codes, etiology flowed by. Instructional notes also indicate when additional codes are required to fully describe the condition you are coding. For instance, if a patient has a diabetes, the coder may use the code E11. 7th Character Certain ICD-10-CM categories have applicable 7th characters. Use additional code. -) •Tobacco use (Z72. 5, N18. – The code for the underlying disease will also have an instructional note in the Tabular List to “use additional code” for the manifestation. Wherever such a combination exists there is a “use additional code” note at the etiology code, and a “code first” note at the manifestation code. 0) CONVENTIONS 12 • Instructional Notes •“Code also” ‐alerts coder that more than one code may be required to describe the condition ‐does not provide sequencing directionsmanifestation. Give an example of a code that contains an instructional note. There is no information of the infectious agent and no additional code is reported. These conventions are incorporated within the Alphabetic Index and Tabular List of ICD-10-CM as instructional notes. , The "See Also" instructional note refers the coder to another location in the Tabular List. code set based on a system maintained by the World Health Organization. are designated in the ICD-10-CM index by brackets. These instructional notes indicate the proper sequencing order of the codes, etiology followed by manifestation. ↓ See below for any exclusions, inclusions or special notations. A "use additional code" note will normally be found at the infectious disease code, indicating a need for the organism code to be added as a secondary code. Under the Main Term Diabetes in the Index, first-level subterms identify: The specific complication (s) with each type. The instructional note “Use additional code, where applicable, to identify exposure to environmental tobacco smoke (Z77. Select one: a. 6 is assigned. -coder can. Identify the main term below that has an instructional note indicating another main term may need to be referenced providing an additional index entry to report the diagnostic code. These instructional notes indicate the proper sequencing order of the codes, etiology followed by manifestation. 01-Use additional code to specify site and severity of ulcer (L97. 4 , N18. true false Modifiers are used to identify when no procedure is done. Use additional code. followed by the manifestation. If coded incorrectly and missing the instructional notations, it could result in a claim denial or medical record review. 0 is a valid billable ICD-10 diagnosis code for Abdominal distension (gaseous) . Best answers. Pay attention to the instructional notes in the tabular list (see yellow highlighted areas). A "use additional code" note will normally be found at the infectious disease code, indicating a need for the organism code to be added as a secondary code. CHAPTER NOTES (cont. Use Additional Code: Note at the etiology code to alert the coder that a manifestation code is needed. The additional code is always listed after the primary code. Appear in both the tabular list and alphabetic index of ICD-10-CM. The ICD-10-CM Index does have instructional notes to code first the underlying infection. In most cases the manifestation codes will have in the code title, "in diseases. In most cases the manifestation codes will include “in diseases classified elsewhere” in the. The 7th character must always be the 7th character in the data field. Code Also –A “code also” note instructs that two codes may be required to fully describe a condition, but the sequencing of the two codes depends on the severity of the conditions and the reason for the encounter. g. F33. These instructional notes indicate that the etiology code should be listed first followed by the manifestation code. These instructional notes indicate the proper sequencing order of the codes, etiology followed by manifestation. In the ICD-10-CM tabular, the coder will see notes under the Category J91. 20 c. Manifestation. 322, Carrier or suspected carrier of Methicillin-resistant Staphylococcus aureus, and a code for the MRSA infection may both be assigned. At the beginning of Chapter 10, Diseases of the Respiratory System (J00-J99) there is an instructional note to Use additional code, where applicable, to identify tobacco dependence (F17. Wherever such a combination exists there is a 'use additional code' note at the etiology code, and a 'code first' note at the manifestation code. These instructional notes indicate the proper sequencing order of the codes, etiology followed by manifestation. The words indicate an instructional note that directs the coder to sequence the underlying condition before the manifestation. A “code also” note is an instruction that two codes may be required to. 13. Use an additional code to identify the infectious agent. K62. Example: E10. 6 exists, there is a “use additional code” note at the etiology code and a “code first” note at the manifestation code. The instructional notes include terms and diagnoses included and excluded for each code. 01 Conn’s syndrome. g. In most cases the manifestation codes will have in the code title, "in diseases. 011, Postthrombotic syndrome with ulcer of right lower extremity, and L97. 6 is a valid billable ICD-10 diagnosis code for Repeated falls . For such conditions the ICD-10-CM has a coding convention that requires the underlying condition. -underlying condition should be sequenced first. "code first" and "use additional code" are examples of A. Notes provide information on code selection. ) Only use NEC/NOS codes when no further detail is possible. These instructional notes indicate the proper sequencing order of the codes: etiology, followed by manifestation. In the Tabular List, the 6th character 2 is selected to specify the left ovary. instructs the coder to select a code to represent the etiology that caused the manifestation. 89, I51. 891) tobacco dependence (F17. It consists 1. These instructional notes indicate the proper sequencing order of the codes, etiology followed by manifestation. Wherever such a combination exists, there is a “use additional code” note at the etiology code, and a “code first” note at the manifestation code. The "see" instruction following a main term in the Alphabetic Index indicates that another term should be referenced. These instructional notes indicate the proper sequencing order of the codes, etiology followed by manifestation. Wherever such a combination exists there is a "use additional code" note at the etiology code, and a "code first" note at the manifestation code. “Code first” and “Use additional code” notes are also used as sequencing rules in the classification for certain codes that are not part of an etiology/manifestation. usually contains a fourth and/or fifth character of 8 and/or 9. When a code does not exist that accurately describes the procedure/treatement, the coder should report an unlisted code. 0) 11The “code first” note is your hint that two codes may be needed, along with sequencing direction. These instructional notes indicate the proper sequencing order of the codes, etiology followed by manifestation. There is an instructional note use additional code to identify organism. The other instructional note is under category code I85 which says to use an additional code to report alcohol abuse and dependence. These instructional notes indicate the proper sequencing order of the codes, etiology followed by manifestation. 0) 11 Wherever such a combination exists, there is a “use additional code” note at the etiology code, and a “code first” note at the manifestation code. The patient is alcohol dependent. 3) Rationale: A note under the code for type 2 DM with diabetic CKD instructs to use an additional code to identify the stage of CKD (N18. These instructional notes indicate the proper sequencing order of the codes, etiology followed by manifestation. In most cases the manifestation codes will have in the code title, "in diseases. contain a use additional code instruction in the ICD-10-CM tabular list. 83 Rationale: Look in the ICD-10-CM Alphabetic Index for Fatigue. Neither of these two codes are acceptable as the PDX. For influenza NOS (not otherwise specified), ICD-10 directs you to use J11. The instructional notation "USE ADDITIONAL CODE" instructs the coder to: Add a second code to fully code the diagnosis. These instructional notes indicate the proper sequencing order of the codes, etiology followed by manifestation. In most cases the manifestation codes will have in the code title, "in diseases. 110, ASHD, native artery with unstable angina is a ______ code. Wherever such a combination exists there is a "use additional code" note at the etiology code, and a "code first" note at the manifestation code. Z71. B) the condition excluded is not part of the condition represented by the code, but a patient may have both conditions at the same time. 83) Use additional code to identify: chronic total occlusion of coronary artery (I25. These instructional notes indicate the proper sequencing order of the codes, etiology followed by manifestation. 2 is a valid billable ICD-10 diagnosis code for Nausea with vomiting, unspecified . Use additional code for any associated fecal incontinence ( R15 . Wherever such a combination exists, there is a “use additional code” note at the etiology code, and a “code first” note at the manifestation code. The “use additional code” note appears with the code for toxic shock syndrome because it is an infectious disease code that does not identify the specific bacterial or viral organism that caused it,. N30. Wherever such a combination exists, there is a “use additional code” note at the etiology code, and a “code first” note at the manifestation code. In addition, if an index entry requires more than one line. 1 also applies to the following:R94. 44- there is an instructional note that states “use additional code to identify the sepsis. When there is a "code first" note and an underlying. Chapter 3: (PASSWORD: NOS) ICD-10-CM Coding Conventions Coding conventions are instructional notes, punctuation marks, abbreviations, and symbols that are used throughout ICD-10-CM and ICD-10-PCS to provide direction when selecting codes. None of the provided codes (C30. such a combination exists there is a “use additional code” note at the etiology code, and a “code first” note at the manifestation code. Explain the use of V and E codes. includes general notes, inclusion and exclusion notes, "code first" notes, "use additional code" notes and "code also" notes. False T/F - NEC means not elsewhere coded. M48. 65 is a valid billable ICD-10 diagnosis code for Type 1 diabetes mellitus with hyperglycemia . Graph the system and estimate the solution. [E. Which of the following is a valid ICD-10-CM code from the Tabular List of Diseases and Injuries?The “use additional code” note appears at the etiology and a “code first” note at the manifestation code. The coder must use the main term Infection, bacterial, as cause of disease classified, Klebsiella to locate the additional code of B96. 0. General notes. 22, Type 1 diabetes mellitus with diabetic chronic kidney disease. In most cases the manifestation codes will have in the code specific eye involved). 9. ICD-10-CM Coding Tips Instructional Notes and Common Coding Mistakes . ” (See Reference 1) For instance, if a patient has a diabetes, the coder may use the code E11. In most cases the manifestation codes will have in the code title, "in diseases. Used to define, give examples, or both, of the content of a category of ICD-10-CM or of a block of category codes. and more. In most cases the manifestation codes will have in the code title, 'in diseases. ” The draft guidelines for ICD-10-CM do not require the additional code for this condition, but may require it when final guidelines are implemented. Learn Test Match Q-Chat Created by chubut Chapter 3 Terms in this set (20) Conventions include: Instructional notes, Abbreviations, Cross-reference notes, Punctuation marks,. 2x-3y=-2 x+y=-6. A "use additional code" note will normally be found at the infectious disease code, indicating a need for the organism code to be added as a secondary code. Etiology or the first disease must be coded first. These instructional notes indicate the proper sequencing order of the codes, etiology followed by manifestation. These instructional notes indicate the proper sequencing order of the codes, etiology followed by manifestation. A) when the note appears under a code, it is acceptable to use both the code and the excluded code together when applicable. ICD 10 CM ___________ include the following: Instructional notes, Abbreviations, Cross-reference notes, Punctuation marks, and Relational terms. "Code first" notes are also under certain codes that are not specifically manifestation codes but may be due to an underlying cause. 5 is reported for stage 5 CKD. Brackets An instructional note with code N39. The applicable 7 th character is required for all codes within the category, or as the notes in the Tabular List instruct. Codee F10. 9 (sepsis, unspecified organism) with T81. None of these codes. Wherever such a combination exists, there is a “use additional code” note at the etiology code, and a “code first” note at the manifestation code. These instructional notes indicate the proper sequencing order of the codes, etiology followed by manifestation. use additional code for. For such codes, a "use additional code" note will still be present and the rules for sequencing still apply. 1. 0) CONVENTIONS 12 • Instructional Notes •“Code also” ‐alerts coder that more than one code may be required to describe the condition ‐does not provide sequencing directions manifestation. . infection. Wherever such a combination exists, there is a “use additional code” note at the etiology code, and a “code first” note at the manifestation code. When there is a "code first" note and an underlying. These instructional notes indicate the proper sequencing order of the codes, etiology followed by manifestation. -). R13. These instructional notes indicate the proper sequencing order of the codes, etiology followed by manifestation. 1–N18. The Code First note instructs the coder to select a code to represent the etiology that caused the _____. Code the following diagnosis: Fever. "Code first". The following are examples of what type of encounter?-Emergency room encounter-First appointment with new physician. R56. but provide additional instruction. The "use additional code" note will be found under the associated condition code in the "Tabular List of Diseases. Wherever such a combination exists, there is a “use additional code” note at the etiology code, and a “code first” note at the manifestation code. The International Classification of Diseases (ICD) is published by the World Health Organization (WHO) and is used to classify:In the Tabular List at the beginning of Chapter 1, Certain Infectious and Parasitic Diseases (A00-B99) there is a note to use an additional code. Wherever such a combination exists there is a "use additional code" note at the etiology code, and a "code first" note at the manifestation code. It is found in the 2024 version of the ICD-10 Clinical Modification (CM) and can be used in all HIPAA-covered transactions from Oct 01, 2023 - Sep 30, 2024 . ICD-10-CM guideline I. Preview Terms in this set (21) T/F - The abbreviation of NEC is only used in the Index. b. ↓ See below for any exclusions, inclusions or special notations. In most cases the manifestation codes will have in the code title, "in diseases. 9. and more. The abbreviation NEC appears with main terms for which no specific code exists. This notation indicates that use of an additional code. The definition can be found under number 12A, pg. ICD-10-CM Instructional Notes, Chapter 3 Two instructional notes appear with a code if the type of anemia is produced by either a poisoning or an adverse effect of a drug, such as-Code first _____ due to drug or toxin, if applicable (T36-T65), with fifth or sixth character 1-4 or 6-Use additional code for adverse effect, if applicable, to. Notice the instructional notes tell the coder to assign a code for diabetes first (code first any associated diabetic chronic kidney disease). This convention instructs you to “Code first” the underlying condition, followed by etiology and/or manifestations. The see also instruction in the ICD-10-CM index follows a subterm and refers the coder to another main term that: a. " d. 31) •Tobacco dependence (F17. 2 is classified says to use additional code to identify resistance to antimicrobial drugs (Z16. 3 According to the instructional notes for the category code, are the codes for use on the maternal or fetal record,. With: The words "with" or "in" should be interpreted to mean "associated with" or "due to" when it appears in a code title, the Alphabetic Index, either under a main term or subterm, or an instructional note in the Tabular List. Instructional notes, like Inclusion and Excludes notes, are located in the.