When a condition is produced as a manifestation of another condition or a complication of a treatment, disease, or condition, more than one code is needed to clearly define the condition, injury, or disease. This is noted by which instructional note or notes in the ICD manual?

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The instructional notes "code first" and "use additional code" in the ICD manual both indicate situations where more than one code is needed to fully describe a condition. "Code first" is used when the condition being coded is a manifestation of another condition, requiring the underlying condition to be coded first. "Use additional code" is used when an additional code is needed to provide a more complete picture of the diagnosis or to specify a complication of the treatment, disease, or condition.

When a Condition Is Produced as a Manifestation of Another