3 is exempt from POA reporting ( Present On Admission). Relating to Use Additional Code and Code First Instructional Notes: The CODE FIRST note _____. 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. F40. The additions. Adherence to these guidelines when assigning ICD-10-CM diagnosis codes is required under the Health Insurance Portability and. 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. R14. 9. The underlying disease must be first sequenced, accompanied by the manifestation, according to the ICD-10-CM coding rule. combination. 01 Conn’s syndrome. ( True/False) Question. A. In most cases the manifestation codes will include “in diseases classified elsewhere” in the. ↓ See below for any exclusions, inclusions or special notations. Code the following diagnosis: Seizure. These instructional notes indicate the proper sequencing order of the codes, etiology followed by manifestation. 22, Type 1 diabetes mellitus with diabetic chronic kidney disease. More Coding Conventions. These instructional notes indicate the proper sequencing order of the codes, etiology followed by manifestation. True. 1 directs to use an additional code to identify pneumonia or other manifestations. A commonly missed instructional note under N18. contains the code that is to be. 3. 10. The instructional note “Use additional code, where applicable, to identify exposure to environmental tobacco smoke (Z77. 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. 20 c. These instructional notes indicate the proper sequencing order of the codes, etiology followed by manifestation. After work-up it was determined that he has a benign neoplasm of the temporal lobe of his brain. The "use additional code" note is. 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. precalculus. 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. 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. 2x-3y=-2. They may appear independently of each other or to designate certain etiology/manifestation paired codes. xxxx Drug or chemical-induced diabetes mellitus Code first a dx from (T36-T65) Use additional code for adverse effect (T36-T50) E10. 16. In most cases the manifestation codes will have in the code title, "in diseases. Pseudocyst of pancreas Billable Code. 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. 00Wherever 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. In most cases the manifestation codes will have in the code title, "in diseases. g. 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. Question 1. These instructional notes indicate the proper sequencing order of the codes, etiology followed by manifestation. –In the index both conditions are listed together with the. In most cases, the manifestation codes will have in the code title “in diseases classified elsewhere. The SEE ALSO instructional note. In most cases the manifestation codes will have in the code title, "in diseases. It instructs you to code first underlying disease, which in this case, is the cirrhosis of the liver from the alcohol. Neither of these two codes are acceptable as the PDX. The instructional notes include terms and diagnoses included and excluded for each code. The Includes note is used to define, give examples, or both, of the content of a category. In most cases, the manifestation codes will have in the code title “in diseases classified elsewhere. Located at the etiology code and directs you to assign a manifestation code. Found at the etiology code as a clue to identify the manifestations commonly associated with the disease. a list of abbreviations, punctuation, symbols, typefaces and instructional notes appearing int he beginning of ICD-9. usually contains a fourth and/or fifth character of 8 and/or 9. These instructional notes indicate the proper sequencing order of the codes, etiology followed by manifestation. It is necessary to go to the main term referenced with the "see" note to locate the correct code. -) Use additional code to identify stage of chronic kidney disease ( N18. Inclusion notes. 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 code I25. 83) Use additional code to identify: chronic total occlusion of coronary artery (I25. 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 . Code First/Use Additional Code notes (etiology/manifestation paired codes) Certain conditions have both an underlying etiology and multiple body system. 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. In addition to coding the respiratory system condition in ICD-10-CM, there is an instructional note in many of the subclassifications in chapter 10, as shown here: Diseases of the respiratory system (J00–J99) Use additional code, where applicable, to identify: exposure to environmental tobacco smoke (Z58. 22) •History of tobacco use (Z87. The following are examples of what type of encounter?-Emergency room encounter-First appointment with new physician. ICD-10-CM;The instructional note: Use additional code (B95–B97) to identify infectious agent appears under several codes in the tabular. The additional code is always listed after the primary code. 891) tobacco dependence (F17. 7, I51. Instructional notes, punctuation marks, abbreviations, and symbols. Excludes 1: fever and chills. 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 such a combination exists there is a "use additional code" note at the etiology code, and a "code first" note at the manifestation code. " ICD-10-CM Coding Conventions The conventions for ICD-10-CM are the general rules for using the classification independent of the guidelines. – The code for the underlying disease will also have an instructional note in the Tabular List to “use additional code” for the manifestation. Look for Cirrhosis/liver/alcoholic and you are directed to K70. As with all DM categories, an Excludes 1 note excludes all other DM, including gestational, neonatal, and postprocedural. that the condition excluded is not part of the condition represented by the code, but a patient may have both conditions at the same time. d. This would code: Fibrillation > atrial > postoperative complication > paroxysmal. "Code first" notes are also under certain codes that are not specifically manifestation codes but may be due to an underlying cause. 22) history of tobacco use (Z87. 16. 0 (paroxysmal atrial fibrillation) based on the instructional note to use an additional code to specify the. 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. 891) tobacco dependence (F17. Example: Type 2 diabetes with stage three chronic kidney disease combination exists there is a “use additional code” note at the etiology code and a “code first” note at the manifestation code. When you look up this code in the Tabular List, you’ll find an instructional note to “Code also” adrenal adenoma (D35. located below certain codes in the tabular list. Laterality and 7 thCategory J32. 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. In the tabular, code G31. 890. and more. K90. instructional notes. 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. About us. 1 should be reported as the principal or first diagnosis, regardless of whether the patient's most recent COVID-19 test. 8x has a “use additional code to identify delirium and dementia w/with behavioral disturbance at the beginning of the G30/Alzheimer’s disease section. 7th Character Certain ICD-10-CM categories have applicable 7th characters. 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. N30. Abbreviations The "Use additional code" _____. In most cases the manifestation codes will have in the code title, "in diseases. 1. Sam was admitted due to a loss of consciousness. 9. appears in the Tabular NOS means not otherwise specified. The "Excludes" notes give examples of the content of a section of the code book. c. E26. Possible conventions to include with codes include the following: Notes: Extra information to define or clarify code choice. 6 %âãÏÓ 72708 0 obj > endobj 72713 0 obj >/Filter/FlateDecode/ID[1436CD2AA15C98D34D807083E14FC741>]/Index[72708 14]/Info 72707 0 R/Length 49/Prev 4862096. instructs the coder to use an additional code to identify the manifestation that is present. 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 . 9 (Diabetes mellitus type 2 without complications) to code this diagnosis. The "use additional code" note will be found under the associated condition code in the "Tabular List of Diseases. J30. In this case the patient has end stage renal disease so N18. 1 is a valid billable ICD-10 diagnosis code for Solitary pulmonary nodule . What is the instruction provided in the note below code E10. 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. A use additional code note is present at category D70 which instructs to “Use additional code for any associated: fever (R50. 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 there is a 'use additional code' note at the etiology code, and a 'code first' note at the manifestation code. There is an instructional note under category code K70 to use additional code to identify alcohol abuse and dependence. 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. There is an instructional note to code also the type of asthma, if applicable (J45. 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. 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 for any associated physical or developmental disorders. appears in the Tabular NOS means not otherwise specified. 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. and more. xxx Diabetes mellitus due to underlying condition Include the underlying condition diagnosis E09. “See” and “See Also” –The “see” instruction following a main term in the And if you scroll down a little farther to N18. 83 Rationale: Look in the ICD-10-CM Alphabetic Index for Fatigue. detail to ensure the code assignment is not affected. Basically stated, ICD-10-CM requires you to sequence the underlying condition first “if applicable, followed by the manifestation. Selected Answer: is not used in ICD coding. 2 25 Excludes _____ note is used when two conditions cannot be used together. In most cases the manifestation codes will have in the code title, "in diseases. These instructional notes indicate the proper sequencing order of the codes, etiology followed by manifestation. 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. These are in red type and also dictate sequencing of the codes with phrases like, ‘use additional code,’ meaning you will. true. When the term “and” is used in a statement, it may be interpreted as, “and/or”. These instructional notes indicate the proper sequencing order of the codes, etiology followed by manifestation. algebra2. This code is sequenced second because the reason the patient was admitted was to treat the hepatitis. Z71. 83)ICD 10 Code Description Notes E08. 111. These are sequencing instructions that must be followed. ICD-10-CM Coding Conventions The conventions for ICD-10-CM are the general rules for using the classification independent of the guidelines. These instructional notes indicate the proper sequencing order of the codes, etiology followed by manifestation. In the Alphabetic Index, following the main term “sequela,” is the direction term “see also condition” to remind the coder that other entries in the Alphabetic Index are. F33. NEC means not elsewhere classifiable 2. 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. ↓ See below for any exclusions, inclusions or special notations. There is advice at the beginning of this chapter to use an additional code to identify resistance to antimicrobial drugs using. Example: E10. 88 Other and unspecified bacterial agents as the cause of diseases classified to other chapters. d. These instructional notes indicate the proper sequencing order of the codes, etiology followed by manifestation. The "see" instruction following a main term in the Alphabetic Index indicates that another term should be referenced. code first underlying disease. "code first" and "use additional code" are examples of A. 0 is a valid billable ICD-10 diagnosis code for Dehydration . The "code first" note is. CMS. 1. 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 . " In the "Index to Diseases," the multiple coding requirement is indicated by the use of the slanted brackets. For instance, if a patient has a diabetes, the coder may use the code E11. 10 is a valid billable ICD-10 diagnosis code for Social phobia, unspecified . 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. There is no mention of vomiting. These instructional notes indicate the proper sequencing order of the codes, etiology followed by manifestation. means "not coded here" The "code first" note _____. ICD-10-CM;• Read full code descriptors and instructional notes • see, see also, see category • with or without. 6). Manifestation code = “code 1st” These instructional notes indicate the proper sequencing order of the codes 3. 2 is classified says to use additional code to identify resistance to antimicrobial drugs (Z16. These instructional notes indicate the proper sequencing order of the codes, etiology followed by manifestation. 31) •Tobacco dependence (F17. A list of abbreviations, punctuation, symbols, typefaces, and instructional notes appears at the beginning of the ICD-9. 9. 9 (Diabetes mellitus type 2 without complications) to code this diagnosis. , Instructional notes appear in both the Tabular List and Alphabetic Index of ICD-10-CM. conventions. 850 is a valid billable ICD-10 diagnosis code for Homicidal ideations . 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. Diseases of the Eye and Adnexa. This notation indicates that use of an additional code may provide a more complete picture of the diagnosis or procedure. 0. Even with the availability of many combination codes, there are some subcategories that have a “Use additional code” instruction. -)R45. There are also instructional notes to use additional code to identify specific organ dysfunction. Some categories of codes (e. The "use additional code" note will be found under the associated condition code in the "Tabular List of Diseases. ICD-10-CM Coding Tips Instructional Notes and Common Coding Mistakes . 7 th Characters Certain ICD-10-CM categories have applicable 7 th characters. J06. In most cases the manifestation codes will have in the code title, "in 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. K86. In most cases the manifestation codes will have in the code specific eye involved). Code N18. A. 1 states to not assign codes from category Z34 with Chapter 15 codes. 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. Codes with this phrase are never used as a first-listed or principal diagnosis. In most cases the manifestation codes will have in the code title, "in diseases. There is an instructional note with I87. Use additional code for any associated fecal incontinence ( R15 . 10. The patient is also a type 1 diabetic with diabetic retinopathy and diabetic neuropathy. 6 also applies to the following: Inclusion term. 13. In most cases, the manifestation codes will have in the code title “in. 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. These instructional notes indicate the proper sequencing order of the codes, etiology followed by manifestation. An instructional note in ICD-10-CM for intellectual disabilities (F70 through F79) directs coders to: a. The diagnosis codes (Tabular List and Alphabetic Index) have been adopted under HIPAA for all healthcare settings. ICD-10-CM: type 2 DM with diabetic CKD (E11. includes notation C. The implementation of ICD-10-CM coding brought about significant changes to the world of coding. Explain the use of V and E codes. As a result, it is crucial to follow the symbols, conventions, instructional notes, and guidelines mentioned throughout the book. The 7th character must always be the 7th character in the data field. 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. Explain two (2) methods you will use to build good coding habits. , specific ear diseases) may be more extensive, contain additional. These instructional notes indicate the proper sequencing order of the codes (etiology followed by manifestation). 0-). Correct Answer : Add an additional character to the code . 5. Codes First and Use Additional Code Notes Coding convention used in ICD-10-CM that directs the coder as to which condition is coded first is known as a “code first” note. In most cases the manifestation codes will have in the code title, "in diseases. R10. A. 40 is a valid billable ICD-10 diagnosis code for Major depressive disorder, recurrent, in remission, unspecified . Codee F10. 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. True B. There is a "Use Additional Code" notation at the etiology code and a "Code First" note at the manifestation code whenever such a combination exists. i. tracheobronchitis to bronchitis in. Etiology or the first disease must be coded first. Code First/Use Additional Code notes (etiology/manifestation paired codes) Certain conditions have both an underlying etiology and multiple body system manifestations due to the underlying etiology. 13. use both the code and the excluded code together. F10. The instructional notation "USE ADDITIONAL CODE" instructs the coder to: Add a second code to fully code the diagnosis. In this example, assigning. 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. These instructional notes indicate the proper sequencing order of the codes, etiology followed by manifestation. Use an additional code to identify the infectious agent. This note signals that an additional code is necessary to fully. 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. This convention instructs you to “Code first” the underlying condition, followed by etiology and/or manifestations. such a combination exists there is a “use additional code” note at the etiology code, and a “code first” note at the manifestation code. Mar 5, 2021. 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. The coder must use the main term Infection, bacterial, as cause of disease classified, Klebsiella to locate the additional code of B96. Read and be guided by the instructional notes in both indexes The Alphabetical Index does not always provide the full code. ) Assign combination codes when available. Examples of these notes include: Use additional code to identify the infectious agent; Use additional code to identify the virus; Code first any associated lung abscessCode First/Use additional code These instructional notes provide sequencing instruction. These instructional notes indicate the proper sequencing order of the codes, etiology followed by manifestation. These instructional notes. In most cases the manifestation codes will have in the code title, "in diseases. 0. Largo, FL. 8, B96. Notice the instructional notes tell the coder to assign a code for diabetes first (code first any associated diabetic chronic kidney disease). These instructional notes indicate the proper sequencing order of the codes, etiology followed by manifestation. 673 is a valid billable ICD-10 diagnosis code for Pain in unspecified foot . Includes Note. In most cases the manifestation codes will have in the code title, "in diseases. The “code first” note is an instructional note. • 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 . 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 . 211 itional code to indicate precipitate labor 062. These items provide guidelines for using the code set. 0) is reported as the PDX followed by the code for the heart failure (I50. It consists 1. use additional code for any associated physical or developmental disorders. In most cases the manifestation codes will have in the code title, "in diseases. Category J05 Use Additional code note and Code Also 9. 89, I51. Z98. 0 is a valid billable ICD-10 diagnosis code for Abdominal distension (gaseous) . When it applies, codes missing this character are. 0 in the Tabular. 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. 65 is a valid billable ICD-10 diagnosis code for Type 1 diabetes mellitus with hyperglycemia . R13. 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. precalculus. ↓ See below for any exclusions, inclusions or special notations. Use Additional Code. 0 also applies to the following: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. * Because in ICD-10-CM coding coder first assi. c. In most cases the manifestation codes will have in the code title, "in diseases. Code N75. following previous Cesarean delivery 034. The guidelines in ICD-9-CM include an additional instructional note to “Use an additional code to identify the stage of chronic kidney disease. ICD 10 CM ___________ include the following: Instructional notes, Abbreviations, Cross-reference notes, Punctuation marks, and Relational terms. 2. followed by the manifestation. “Code first” and “Use additional code” notes are also used in. Create flashcards for FREE and quiz yourself with an interactive flipper. R11. -). if instructional phrase or condition is found after main term or anatomical site has been mistakenly referenced instead of disorder or disease documented in diagnostic statement. See Note: an instruction following the main term in the Alphabetic Index that indicates that another term should be referenced - for correct coding it is necessary to go to the main term referenced with this note. These instructional notes indicate the proper sequencing order of the codes, etiology followed by manifestation. (See Appendix A, Section I. Select one: a. If a code. ↓ See below for any exclusions, inclusions or special notations. Look for Cirrhosis/liver/alcoholic and you are directed to K70. 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. On the etiology side, the etiology/manifestation combination is signaled by the instructional note “use additional code,” present at the level of the category. F43. b. infection. R13. -) Use additional code to identify stage of chronic kidney disease ( N18. 22? “Use additional code” to identify stage of chronic kidney disease (N18. Best answers. After looking up a code in the Alphabetic Index it should be verified by checking the __. An instructional note in the Tabular List instructs us to use an additional code to identify alcohol and/or tobacco use and/or dependence, history of tobacco dependence, and/or exposure to tobacco smoke. N18. 9) Under the Category I50 in the ICD-10-CM. assign an additional code only if the “additional” condition is documented in the health record as being present. ↓ See below for any exclusions, inclusions or special notations. CPC Prep Course Chapter 3 Notes. This notation indicates that use of 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. ) Assign combination codes when available. N18. When there is a “code first” note and an underlying condition is present, the underlying condition is sequenced first. means "not coded here" The "code first". These instructional notes indicate the proper sequencing order of the codes, etiology followed by manifestation. A 3-year-old patient was brought in to the physician's office by her mother because of fever, fussiness, and tugging at the right ear. 59 (and not a code from category 438) as an additional code for history of cerebrovascular disease when no neurologic deficits are present. K90. In most cases the manifestation codes will have in the code title, "in diseases. 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, and Relational terms ("and," "with," "without," "due to"). c. a. 42 is a valid billable ICD-10 diagnosis code for Type 2 diabetes mellitus with diabetic polyneuropathy . There are times when a single condition may require multiple coding. Otoscopy confirmed acute infection of the canal, with erythema and pus in the canal noted on exam. When there is a "Code first" note and an underlying condition is present the:-instructional note (Code first) should be followed. 22)” applies to. general notes, inclusion and exclusion notes, code first notes, use additional code notes, and code also notes. 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. Check the solution algebraically . 4 , N18. Some categories of codes (e. Korsakoff's (Wernicke) disease, psychosis or. 2. 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. 1, C34. “These are the ‘code first,’ ‘use additional code,’ and ‘in diseases classified elsewhere’ notes you see in the Tabular section of ICD-10,” Blanchard. C. This notation indicates that use of an additional. includes general notes, inclusion and exclusion notes, "code first" notes, "use additional code" notes and "code also" notes. Verify the codes in the tabular list and assign codes in this order: I87. 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.