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 indicate that more than one code is needed to fully describe a condition where one is a manifestation of another or a complication arises. "Code first" instructs which condition should be coded initially, while "use additional code" indicates that an additional code is needed to provide a more complete picture of the diagnosis.

When a Condition Is Produced as a Manifestation of Another