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 situations where more than one code is needed to fully describe a condition. "Code first" is used to indicate that a primary condition should be coded before a related condition, while "Use additional code" instructs to add another code to provide more detail about the condition or to indicate a complication or manifestation.

When a Condition Is Produced as a Manifestation of Another