Question

multiple choice question

the instruction \______\ appears below a manifestation code that must not be used as a first-listed code.

manifestation coding
etiology coding
use additional code
code first underlying disease

Explanation:

Analyze the question prompt

The question asks for the specific instructional note that appears below a manifestation code in ICD-10-CM, indicating that the manifestation code cannot be sequenced as the primary or first-listed diagnosis.

Identify the coding convention

Using the Etiology Manifestation Convention knowledge point

• ICD-10-CM utilizes a "dual coding" system for conditions that have both an underlying etiology (cause) and multiple body system manifestations.
• The etiology code must be sequenced first, followed immediately by the manifestation code.

Determine the instructional note

Using the ICD-10 Instructional Notes knowledge point

• To enforce this sequencing rule, manifestation codes in the Tabular List are accompanied by an instructional note.
• This note is explicitly written as "code first underlying disease".
• This instruction directs the coder to sequence the underlying etiology code before the manifestation code.

Evaluate the given options

• "manifestation coding": This is a general concept, not an instructional note.
• "etiology coding": This is a general concept, not an instructional note.
• "use additional code": This note appears at the etiology code to instruct the coder to add the manifestation code as a secondary code.
• "code first underlying disease": This note appears at the manifestation code to instruct the coder that the etiology code must be sequenced first.

Answer:

• manifestation coding
• etiology coding
• use additional code
• code first underlying disease (Correct answer)