These instructional notes indicate the proper sequencing order of the codes, etiology followed by manifestation. This convention instructs you to “Code first” the underlying condition, followed by etiology and/or manifestations. Manifestations are listed as additional codes. Sam was admitted due to a loss of consciousness. 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 . -) •Tobacco use (Z72. These instructional notes indicate the proper sequencing order of the codes, etiology followed by manifestation. Z71. 0-). " Discuss whether or not it is correct to follow the instructional note below as written and assign A41. 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. 9) Under the Category I50 in the ICD-10-CM. 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. 102. For instance, if a patient has a diabetes, the coder may use the code E11. These instructional notes indicate the proper sequencing order of the codes, etiology followed by manifestation. [E. In most cases the manifestation codes will have in the code title, "in diseases. Good morning, I am wanting to clarify some red instructional notes in the code book. 0. 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. instructional notes. The diagnosis codes (Volumes 1-2) have been adopted under HIPAA for all healthcare settings. 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. These instructional notes indicate the proper sequencing order of the codes, etiology followed by manifestation. In most cases the manifestation codes will have in the code title, "in diseases. 0 indicates to use additional code to identify the stage of the CKD. 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 . xxxx Type 1 diabetes mellitus3. If the coder sees a "see" note, they should follow the cross-reference to where it tells you to go to review extra entries in the index. These instructional notes indicate the proper sequencing order of the codes, etiology followed by manifestation. It's in Section I. These instructional notes indicate the proper sequencing order of the codes, etiology followed by manifestation. 1–N18. 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. These instructional notes indicate the proper sequencing order of the codes, etiology followed by manifestation. You are directed to R11. but provide additional instruction. 0 (paroxysmal atrial fibrillation) based on the instructional note to use an additional code to specify the. 59 (and not a code from category 438) as an additional code for history of cerebrovascular disease when no neurologic deficits are present. Adherence to these guidelines when assigning ICD-10-CM diagnosis codes is required under the Health Insurance Portability and. Chapter 3: (PASSWORD: NOS) ICD-10-CM Coding Conventions Coding conventions are instructional notes, punctuation marks, abbreviations, and symbols that are used throughout ICD-10-CM and ICD-10-PCS to provide direction when selecting codes. Laterality and 7 thCategory J32. Codes from category 438 may be assigned on a health care record with codes from 430-437, if the patient has a current CVA and deficits from an old CVA. In addition,. Also indicates the etiology code is to be first listed before the manifestation code. and more. When there is a “code first” note and an underlying condition is present, the underlying condition is sequenced first. 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. means "not coded here" The "code first". 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. 0. 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. ↓ See below for any exclusions, inclusions or special notations. This is addressed in guideline 1. ” Per the coding guidelines, this instructional note is found in the Tabular List with codes that are not part of an etiology/manifestation pair where a secondary code is useful to fully describe a condition. 01-Use additional code to specify site and severity of ulcer (L97. sometimes used to inform, describe circumstances or give additional information about a term or. The placement of an Includes note signifies the section of the code book that the note. 1 directs to use an additional code to identify pneumonia or other manifestations. In this case, the PDX of hypertensive heart disease with CHF (I11. There are times when a single condition may require multiple coding. Is used to define, give examples, or both, of the content of the category of ICD 10 CM or of a block of category codes. “Code first” and “Use additional code” notes are also used as sequencing rules in the classification for certain codes that are not part of an etiology/manifestation. 0) is reported as the PDX followed by the code for the heart failure (I50. assign an additional code only if the “additional” condition is documented in the health record as being present. These instructional notes indicate the proper sequencing order of the codes, etiology followed by manifestation. A "use additional code" note will normally be found at the infectious disease code, indicating a need for the organism code to be added as a secondary code. 89 is a valid billable ICD-10 diagnosis code for Other specified diseases of anus and rectum . In the Tabular List, the 6th character 2 is selected to specify the left ovary. 8, B96. A "use additional code" note will normally be found at the infectious disease code, indicating a need for the organism code to be added as a secondary code. but provide additional instruction. In addition, if an index entry requires more than one line. These instructional notes indicate the proper sequencing order of the codes, etiology followed by manifestation. " In the "Index to Diseases," the multiple coding requirement is indicated by the use of the slanted brackets. ICD-10-CM;The instructional note: Use additional code (B95–B97) to identify infectious agent appears under several codes in the tabular. Instructional notes, like Inclusion and Excludes notes, are located in 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. The patient is also a type 1 diabetic with diabetic retinopathy and diabetic neuropathy. 01 Conn’s syndrome. 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. Coding Guidelines and Instructional Notes for ICD-10-CM Chapter 1 0 Instructional note appears at beginning of chapter, "when a respiratory condition is described as occurring in more than one site and is not specifically indexed, it should be classified to the lower anatomic site" Use additional codes, where applicable, to identify o Exposure. 2. The Instructional Note under code U07. Instructional notes include. In most cases the manifestation codes will have in the code title, "in diseases. When using code n52. 01 Conn’s syndrome. Some people are interpreting a "use additional code" note to mean that the secondary code must always appear in the diagnosis field immediately following the. ↓ See below for any exclusions, inclusions or special notations. These instructional 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 . [Brackets] are an ICD-10-CM convention indicating the enclosed code is a manifestation code 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 Tabular Use of "Code also" or "Use Additional code" Instructions in ICD 10 coding for medical coders. -). These instructional notes indicate the proper sequencing order of the codes, etiology followed by manifestation. When using code R45. The instructional notation "USE ADDITIONAL CODE" instructs the coder to: Add a second code to fully code the diagnosis. E11. ( True/False) Question. 82) exposure to environmental tobacco smoke (Z77. antonyms of code titles or "unspecified" terms. Includes Note. They may appear independently of each other or to designate certain etiology/manifestation paired codes. Instructional notes indicate the proper sequencing order of these conditions-etiology (underlying condition) followed by manifestation. A list of abbreviations, punctuation, symbols, typefaces, and instructional notes appears at the beginning of the ICD-9. 81). 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 . Thromboarteritis - see arteritis. The "Use additional code" _____. 3) Rationale: A note under the code for type 2 DM with diabetic CKD instructs to use an additional code to identify the stage of CKD (N18. The anemia is documented to be due to end stage renal disease (ESRD) after workup. The additional code referenced with the “see” note to locate the correct code. ICD-10-CM guideline I. Below are just some of the ICD-10-CM guidelines I use and reference on a regular basis: Guideline Section IA:13 – Etiology/Manifestation Convention – Code first and Use additional code notes are sequencing rules in the classification of certain codes that are not part of an. A. These instructional notes indicate the proper sequencing order of the codes, etiology followed by manifestation. The Code First note instructs the coder to select a code to represent the etiology that caused the _____. infection. ” (See Reference 1) For instance, if a patient has a diabetes, the coder may use the code E11. Parallel ICD-9-CM Code Guidelines Increased Instruction Notes (Code first; Use Additional Code) Enhanced Combination Codes Updated Terminology to Reflect Current Medical Practices COPD (J44-J45) Acute exacerbation is a worsening or decompensation of a chronic condition An acute exacerbation is NOT equivalent to an infectionin ICD-10-CM/PCS uses an indented arrangement. Inclusion notes. You must use the applicable 7th character for all ICD-10-CM codes within the category or as notes in the Tabular List instruct. K86. 2 25 Excludes _____ note is used when two conditions cannot be used together. CODING CONVENTIONS. 9 (Diabetes mellitus type 2 without complications) to code this diagnosis. …The instructional note “Use additional code” (B95–B97) is found in the Tabular List of ICD- 10-CM under Code N39. In most cases the manifestation codes will have in the codeThe SEE instructional note. 20. 89 (other post-procedural complications and disorders of the circulatory system, not elsewhere classified) and I48. 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. Pseudocyst of pancreas Billable Code. 1 should be reported as the principal or first diagnosis, regardless of whether the patient's most recent COVID-19. In this example, assigning. ↓ See below for any exclusions, inclusions or special notations. 2 is a valid billable ICD-10 diagnosis code for Nausea with vomiting, unspecified . provide general information on usage in a specific section. For such conditions the ICD-10-CM has a coding convention that requires the underlying condition be sequenced first followed by the manifestation. . However, if the coder also sees the instructional note of "Use an Additional Code" in the ICD 10 CM Code Book in the Tabular List, the coder would then also provide an additional code to provide. 6 is assigned. There is an instructional note under category code K70 to use additional code to identify alcohol abuse and dependence. 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. b. See also instructional note Refers the coder to another location in the alphabetic index when the initial listing does not contain all the necessary information to accurately select a code. ) Assign multiple codes when required (usually coder will be guided to do this by additional instructional notes in the ICD-9. ) • Use additional code to identify resistance to antimicrobial drugs (Z16) • New section called infections with a predominantly sexual mode of transmission (A50–A64) • When coding sepsis or AIDS, it is important to review the Coding Guidelines and the notes at the category level of ICD-10-CMThe “use additional code” note appears at the etiology and a “code first” note at the manifestation code. In most cases, the manifestation codes will have in the code title “in. This indicates the sequencing. b. You should never use the exculde1 code at the same time as the code above Excludes1 notes. ↓ See below for any exclusions, inclusions or special notations. 01. These are sequencing instructions that must be followed. CMS. Multiple Codes. 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. 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 . 20 is assigned a tthe direction of the "use additional code to identify alcohol use and dependence (F10. An instructional note will be found at the infection code advising that an additional organism code is required. Instructional notes also indicate when additional codes are required to fully describe the condition you are coding. In most cases the manifestation codes will have in the code title, 'in diseases. Table of Neoplasms. The additional code is always listed after the primary code. ICD-10-CM: type 2 DM with diabetic CKD (E11. The 7th character must always be the 7th character in the data field. ↓ See below for any exclusions, inclusions or special notations. Graph the system and estimate the solution. -) Use additional code to identify stage of chronic kidney disease ( N18. instructs the coder to use an additional code to identify the manifestation that is present. R13. 6 %âãÏÓ 72708 0 obj > endobj 72713 0 obj >/Filter/FlateDecode/ID[1436CD2AA15C98D34D807083E14FC741>]/Index[72708 14]/Info 72707 0 R/Length 49/Prev 4862096. Use an additional code to identify the infectious agent. 1 is a valid billable ICD-10 diagnosis code for Solitary pulmonary nodule . are introduced by the word "includes" when placed at the beginning of a chapter or section. 6. In the tabular, code G31. ↓ See below for any exclusions, inclusions or special notations. d. – The code for the underlying disease will also have an instructional note in the Tabular List to “use additional code” for the manifestation. See cross-references lead the coder to another main term; see also suggest additional possible key terms. 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. These instructional notes indicate the proper sequencing order of the codes, etiology followed by manifestation. ↓ See below for any exclusions, inclusions or special notations. In most cases the manifestation codes will have in the code title, "in diseases. Added instructional notes and inclusion terms Code Description G97. The instructional notes to code first the underlying physiological condition are found at the category level. In most cases the manifestation codes will have in the code title, "in diseases. This code is sequenced second because the reason the patient was admitted was to treat the hepatitis. Coders will see the same “code first” instruction when looking at malignant ascites. These instructional notes indicate the proper sequencing order of the codes, etiology followed by manifestation. " d. 3. c. 9. 12. exists there is a 'use additional code' note at the etiology code, and a 'code first' note at the. Z98. 83)ICD 10 Code Description Notes E08. When you look up this code in the Tabular List, you’ll find an instructional note to “Code also” adrenal adenoma (D35. These instructional notes indicate the proper sequencing order of the codes, etiology followed by manifestation. This note indicates that an additional code should be used, if available. In addition,. Another important instructional note is “Use additional code,” which can lead to querying for clarification of organ dysfunction that may be present, see the. Look for Cirrhosis/liver/alcoholic and you are directed to K70. Table of Drugs and Chemicals. 9 is a valid billable ICD-10 diagnosis code for Obesity, unspecified . Category O02 Use additional code note and excludes1 note 10. In Diseases Classified Elsewhere. 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. Use "additional code" note OB. , Modifiers are used to identify when no procedure is done. Guideline Section IA:13 – Etiology/Manifestation Convention – Code first and Use additional code notes are sequencing rules in the classification of certain codes that are not part of an etiology/manifestation combination. Found at the etiology code as a clue to identify the manifestations commonly associated with the disease. 8. Under the Main Term Diabetes in the Index, first-level subterms identify: The specific complication (s) with each type. d. 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 codes would be I97. What is the ICD-10-CM code for fatigue? R53. When there is a "code first" note and an underlying. Excludes 1: atypical face pain due to fever and chills. A. -)" instructional note under category K70. and more. QUESTION 1 4 points Sa In the ICD 10 CM manual which type of instructional note is used in the Tabular List of Diseases to identify a. 12. Code the following diagnosis: Seizure. 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 . 1, C34. 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. 00, N30. These instructional notes indicate the proper sequencing order of the codes, etiology followed by manifestation. Look at code E10. ↓ See below for any exclusions, inclusions or special notations. In most cases, the manifestation codes will have in the code title, “in. These instructional notes indicate the proper sequencing order of the codes, etiology followed by manifestation. In most cases the manifestation codes will have in the code title, "in diseases. 891) tobacco dependence (F17. In ICD coding, the code first is not used. 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. 3 is a valid billable ICD-10 diagnosis code for Pseudocyst of pancreas . 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. True Which of the following is a valid ICD-10-CM code from the Tabular List of Diseases and Injuries? “Code first” notes are under certain codes that are not specifically manifestation codes but may be due to an underlying cause. Use the code(s) in brackets in addition to the disease or condition to identity an associated manifestation. algebra2. They may appear independently of each other or to designate certain etiology/manifestation paired codes. which may or may not be followed by the ICD-9-CM code number, nonessential modifiers, or followed by Instructional Notes. In most cases the manifestation codes will have in the. Verify code selection in the Tabular List. All ICD-10-CM Index to Diseases and Injuries subterms associated with an index entry's main term are indented two spaces, with any 2nd and 3rd qualifiers associated with the main term further indented by two and four spaces, respectively. ) Assign combination codes when available. F43. 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. instructional notes. 1. When there is a "code first" note and an underlying. –In the index both conditions are listed together with the. -) •Tobacco use (Z72. 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. 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. 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. 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. Similar to ICD-9-CM, "Code first" and "Use additional code" notes are present for some of the diabetes mellitus categories and subcategories that require the underlying condition be sequenced first, followed by the manifestation. 0. N18. b. Code H27. An instructional note with category Z16 says to code first the infection. Study with Quizlet and memorize flashcards containing terms like List the three diagnoses that are included as described by the "inclusion note" for code R56. ) Assign multiple codes when required (usually coder will be guided to do this by additional instructional notes in the ICD-9. a. Pay attention to the instructional notes in the tabular list (see yellow highlighted areas). Neither of these two codes are acceptable as the PDX. ICD-10-CM Coding Tips Instructional Notes and Common Coding Mistakes . In most cases the manifestation codes will have in the code title, "in diseases. Codes B95-B97 are secondary codes to. Use Additional Code: Note at the etiology code to alert the coder that a manifestation code is needed. These instructional notes indicate the proper. K62. The instructional notes include terms and diagnoses included and excluded for each 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 most cases, the manifestation codes will have in the code title “in. -). The "Excludes" notes give examples of the content of a section of the code book. Code First/Use Additional Code Notes –Etiology/manifestation paired codes have a specific index entry structure . In most cases the manifestation codes will have in the code title, "in diseases. 0 Acute cystitis . R14. 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. instructional notes, and may also require coding to a higher degree of specificity than indicated here. ↓ See below for any exclusions, inclusions or special notations. 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. The Instructional Note under code U07. 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. CHAPTER NOTES (cont. First notes indicate that this code may be assigned as first-listed diagnosis when the casual condition is? Un known/ Not Applicable. ) Courtesy of the Centers for Medicare & Medicaid Services, 3-1d See Also Instructional Note Another cross-reference note used in ICD-10-CM, the See Also note refers the coder to another location in the Alphabetic Index when the initial listing does not contain all the necessary information to. Code N75. Code if applicable, any casual condition. In most cases the manifestation codes will have in the code title, "in diseases. In the tabular list, code first and use additional code instructional notes indicate the proper sequencing order of what conditions Certain conditions that have both an underlying etiology and multiple body system manifestations due to the underlying etiology instructional notes indicate a proper sequencing order of these conditions etiology. 891) •Occupational exposure to environmental tobacco smoke (Z57. Use additional code. -). 83 Rationale: Look in the ICD-10-CM Alphabetic Index for Fatigue. These instructional notes indicate the proper sequencing order of the codes, etiology followed by manifestation. Wherever an etiology and manifestation combination of codes exists, the manifestation code contains an instructional note to: use of an additional code The International Classification of Diseases (ICD) is published by the World Health Organization (WHO) and is used to classify: 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. ↓ See below for any exclusions, inclusions or special notations. If a coder sees the instructional note of "Use an Additional Code" in the ICD 10 CM Code Book in the Tabular List it is indicating to the coder the following instruction: Q&A. 12. A "use additional code" note will normally be found at the infectious disease code, indicating a need for the organism code to be added as a secondary code. tracheobronchitis to bronchitis in. 31) •Tobacco dependence (F17. 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 flowed by. Otoscopy confirmed acute infection of the canal, with erythema and pus in the canal noted on exam. Use Additional Code. Create flashcards for FREE and quiz yourself with an interactive flipper. Abbreviations The "Use additional code" _____. A list of abbreviations, punctuation, symbols, typefaces, and instructional notes appears at the beginning of the ICD-9-CM. Breakdown the ICD-10-CM Guidelines. Additional terms found only in the Alphabetic Index may also be assigned to a code. false. 1. 1-N18. After work-up it was determined that he has a benign neoplasm of the temporal lobe of his brain. Fully searchable through Find-A-Code's Comprehensive Search. 13. If a code. However, if the coder also sees the instructional note of "Use an Additional Code" in the ICD 10 CM Code Book in the Tabular List, the coder would then also provide an additional code to provide. precalculus. Use additional code to identify type of heart failure (I50. ICD-10-CM;• Read full code descriptors and instructional notes • see, see also, see category • with or without. true. 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 . E86. "Code first". Correct Answer : Add an additional character to the code . These instructional notes indicate the proper sequencing order of the codes, etiology followed by manifestation. In most cases, the manifestation codes will have in the code title “in diseases classified elsewhere. 83. 11, there is a “Code first” instruction for complications of bone marrow transplant and stem cell transplant complication. 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. Often, instructions appear in one place, but aren’t repeated by each code,” said. Codes with this phrase are never used as a first-listed or principal diagnosis. The "use additional code" note is. but provide additional instruction. These instructional notes indicate the proper sequencing order of the codes, etiology followed by manifestation. , specific ear diseases) may be more extensive, contain additional . There is no information of the infectious agent and no additional code is reported. 3. Select one: a. 1R29. Patient is admitted to the hospital with pneumonia due to bacteriodes fragilis, J15. “These are the ‘code first,’ ‘use additional code,’ and ‘in diseases classified elsewhere’ notes you see in the Tabular section of ICD-10,” Blanchard. Code First/Use Additional Code notes (etiology/manifestation paired codes) Certain conditions have both an underlying etiology and multiple body system. -underlying condition should be sequenced first. 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. 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. The code for alcohol dependence is located by indexing the main term "Alcoholism". 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. -) Use additional code to identify stage of chronic kidney disease ( N18. Even with the availability of many combination codes, there are some subcategories that have a “Use additional code” instruction. The definition can be found under number 12A, pg. Group of answer choices. heart involvement. The EXCLUDES 2 note represents all of the following except _____.