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" instructs the coder to first code the underlying condition, while "use additional code" indicates that an additional code should be used to provide more detail about the manifestation or complication.

When a Condition Is Produced as a Manifestation of Another