the use additional code instructional note _____.. 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 use additional code instructional note _____.

 
Wherever such a combination exists there is a "use additional code" note at the etiology code, and a "code first" note at the manifestation codethe  use additional code  instructional note _____.  Excludes 1: atypical face pain due to fever and chills

Selected Answer: is not used in ICD coding. Additional terms found only in the Alphabetic Index may also be assigned to a code. 1 directs to use an additional code to identify pneumonia or other manifestations. You must use the applicable 7th character for all ICD-10-CM codes within the category or as notes in the Tabular List instruct. The instructional note “Use additional code” (B95–B97) is found in the Tabular List of ICD- 10-CM under Code N39. The instructional notation "USE ADDITIONAL CODE" instructs the coder to: Add a second code to fully code the diagnosis. Watch the instructional notes carefully. ) Assign multiple codes when required (usually coder will be guided to do this by additional instructional notes in the ICD-9. ICD-10-CM Instructional Notes, Chapter 3 Two instructional notes appear with a code if the type of anemia is produced by either a poisoning or an adverse effect of a drug, such as-Code first _____ due to drug or toxin, if applicable (T36-T65), with fifth or sixth character 1-4 or 6-Use additional code for adverse effect, if applicable, to. 5. 4. 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. Basically stated, ICD-10-CM requires you to sequence the underlying condition first “if applicable, followed by the manifestation. 1. R10. These instructional notes indicate the proper sequencing order of the codes, etiology followed by manifestation. Etiology/manifestation convention (code first, use additional code and in diseases classified elsewhere notes): Certain conditions have both an underlying etiology and. When it applies, codes missing this character are. 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 TabularUse of "Code also" or "Use Additional code" Instructions in ICD 10 coding for medical coders. 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. ICD-10-CM assumes a causal relationship and this is coded as hypertensive heart disease with CHF and an additional code for the specific type of heart failure. This indicates the sequencing. a. 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. With: The words "with" or "in" should be interpreted to mean "associated with" or "due to" when it appears in a code title, the Alphabetic Index, either under a main term or subterm, or an instructional note in the Tabular List. 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. Z98. Instructs that there is another main term that may also be referenced that may provide additional alphabetic index entries that may be useful. Instructional notes, punctuation marks, abbreviations, and symbols. C. 83 Rationale: Look in the ICD-10-CM Alphabetic Index for Fatigue. The SEE ALSO instructional note. Question: The Code First note instructs the coder to select a code to represent the etiology that caused the manifestation. Code N18. M48. instructional notes. There are multiple additional codes for identified influenza virus infections, including novel A types (avian, swine. Introduction ICD-10 was endorsed by the 43rd World Health Assembly in May 1990 and came into use in WHO Member States in 1994 (including US) The classification is the latest in a series, which has its origins in the 1850s The first edition, known as the International List of Causes of. Social phobia, unspecified Billable Code. "Code first" notes are also under certain codes that are not specifically manifestation codes but may be due to an underlying cause. In most cases the manifestation codes will have in the code title, "in diseases. Verify the codes in the tabular list and assign codes in this order: I87. 4. Located at the etiology code and directs you to assign a manifestation code. The Instructional Note under code U07. are introduced by the word "includes" when placed at the beginning of a chapter or section. 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 code for a condition that is a manifestation of an underlying disease? O A. 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. 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. 0) CONVENTIONS 12 • Instructional Notes •“Code also” ‐alerts coder that more than one code may be required to describe the condition ‐does not provide sequencing directions manifestation. ‐) tobacco use (Z72. If a code. Instructional notes include. 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. For such codes, a "use additional code" note will still be present and the rules for sequencing still apply. The “code first” note is an instructional note. Read and be guided by the instructional notes in both indexes The Alphabetical Index does not always provide the full code. In most cases the manifestation codes will have in the code title, "in diseases. 673 is a valid billable ICD-10 diagnosis code for Pain in unspecified foot . N18. When there is a "code first" note and an underlying. There is an instructional note to code also the type of asthma, if applicable (J45. These instructional notes indicate the proper sequencing order of the codes, etiology followed by manifestation. The instructional notes to code first the underlying physiological condition are found at the category level. There is an instructional note use additional code to identify organism. 11, there is a “Code first” instruction for complications of bone marrow transplant and stem cell transplant complication. You must use the applicable 7th character for all ICD-10-CM codes within the category or as notes in the Tabular List instruct. Whenever such a combination exists, there is a use an 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. 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 . ICD-10-CM guideline, I. , An additional codes instructional note is listed under code 33881. Example: E10. Abbreviations The "Use additional code" _____. 6 is a valid billable ICD-10 diagnosis code for Repeated falls . means "not coded here" The "code first". There is an instructional note use additional code to identify organism. 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. An ICD-10-CM "other specified" code: a. These instructional notes indicate the proper sequencing order of the codes, etiology followed by manifestation. 3. These instructional notes indicate the proper sequencing order of the codes, etiology followed by manifestation. 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 . These instructional notes indicate the proper sequencing order of the codes, etiology followed by manifestation. provide general information on usage in a specific section. Excludes 1: fever and chills. 0 says to use additional code (B95-B97), to identify infectious agent. 9 (Diabetes mellitus type 2 without complications) to code this diagnosis. There is no information of the infectious agent and no additional code is reported. In addition, if an index entry requires more than one line. In most cases the manifestation codes will include “in diseases classified elsewhere” in the. In most cases the manifestation codes will have in the code title, "in diseases. requires the reporting of multiple codes for a case. use additional code for. These instructional notes indicate the proper sequencing order of the codes, etiology followed by manifestation. ICD-10-CM;The instructional note: Use additional code (B95–B97) to identify infectious agent appears under several codes in the tabular. Added instructional notes and inclusion terms Code Description G97. These instructional notes indicate the proper sequencing order of the codes, etiology followed by manifestation. 82) exposure to environmental tobacco smoke (Z77. The “Use additional” code. True. In most cases the manifestation codes will have in the code title, "in diseases. Identify the main term below that has an instructional note indicating another main term may need to be referenced providing an additional index entry to report the diagnostic code. There is an instructional note with I87. E10. This notation indicates that use of an additional code. 1 is a valid billable ICD-10 diagnosis code for Postlaminectomy syndrome, not elsewhere classified . general notes, inclusion and exclusion notes, code first notes, use additional code notes, and code also notes. The EXCLUDES 2 note represents all of the following except _____. What is the ICD-10-CM code for fatigue? R53. 31) •Tobacco dependence (F17. For such codes, there is a "use additional code" note at the etiology code and a "code first" note at the manifestation code. 6). 20 c. As a result, it is crucial to follow the symbols, conventions, instructional notes, and guidelines mentioned throughout the book. 44- there is an instructional note that states “use additional code to identify the sepsis. ↓ See below for any exclusions, inclusions or special notations. 850 is a valid billable ICD-10 diagnosis code for Homicidal ideations . Use an additional code to identify the infectious agent. ) • 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. 0 can also apply to. 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. When there is a "code first" note and an underlying. The point dash appears to signal to the coder that _____. ↓ See below for any exclusions, inclusions or special notations. Chronic kidney disease, stage 3b Billable Code. K86. 15. Chapter 1 of the ICD-10-CM guidelines provides incredibly detailed instruction on coding for sepsis, severe sepsis, and septic shock infections. 96. The see also instruction in the ICD-10-CM index follows a subterm and refers the coder to another main term that: a. false. When there is a “code first” note and an underlying condition is present, the underlying condition is sequenced first. Not necessary Use Additional. 44 (Sepsis following a procedure). -). Without further description you are directed to R53. The additional code referenced with the “see” note to locate the correct code. Tabular List. 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. " In the "Index to Diseases," the multiple coding requirement is indicated by the use of the slanted brackets. 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. true. The note,. Use additional code. There is advice at the beginning of this chapter to use an additional code to identify resistance to antimicrobial drugs using. Verified answer. Used to define, give examples, or both, of the content of a category of ICD-10-CM or of a block of category codes. These instructional notes indicate the proper sequencing order of the codes, etiology followed by manifestation. The additions for FY 2021 presently pushing the number of codes to over 70,000. Codes B95-B97 are secondary codes to. Use the primary code and change the number of units to match the number of biopsies taken Use the appropriate add-on code for a different technique Use the appropriate add-on code for the appropriate technique Use the primary code and only bill one unitE66. ICD-10-CM;• Read full code descriptors and instructional notes • see, see also, see category • with or without. , The "See Also" instructional note refers the coder to another location in the Tabular List. Index of Diseases and Injury. 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. Dysphagia, unspecified Billable Code. View all the articles associated with any code, right from the code page! Study with Quizlet and memorize flashcards containing terms like Four types of conventions: instructional notes, punctuation marks, abbreviations, symbols. 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 . When you look up this code in the Tabular List, you’ll find an instructional note to “Code also” adrenal adenoma (D35. 2). 30. 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. Codes First and Use Additional Code Notes Coding convention used in ICD-10-CM that directs the coder as to which condition is coded first is known as a “code first” note. The other instructional note is under category code I85 which says to use an additional code to report alcohol abuse and dependence. 01 Conn’s syndrome. Use additional code for any associated fecal incontinence ( R15 . In most cases the manifestation codes will have in the code title, "in diseases. Code H27. In most cases the manifestation codes will have in the code title, "in diseases. " ICD-10-CM Coding Conventions The conventions for ICD-10-CM are the general rules for using the classification independent of the guidelines. CHAPTER NOTES (cont. Table of Drugs and Chemicals. -) and a note to use an additional code to identify: •Exposure to environmental tobacco smoke (Z77. There is no information of the infectious agent and no additional code is reported. These instructional notes indicate the proper sequencing order of the codes, etiology followed by manifestation. 65 is a valid billable ICD-10 diagnosis code for Type 1 diabetes mellitus with hyperglycemia . Instructional notes, like Inclusion and Excludes notes, are located in the. These conventions are incorporated within the Alphabetic Index and Tabular List of ICD-10-CM as instructional notes. Square brackets are used: In the Alphabetic Index to enclose the manifestation of a disease. are introduced by the word "includes" when placed at the beginning of a chapter or section. contain a use additional code instruction in the ICD-10-CM tabular list. the use of ICD 9 codes is mandated by HIPAA for. Create flashcards for FREE and quiz yourself with an interactive flipper. A component of. 01 Conn’s syndrome. instructs the coder to select a code to represent the etiology that caused the manifestation. true false Appendix C contains coding examples to assist in the selection of. Check the solution algebraically . 9 is a valid billable ICD-10 diagnosis code for Male erectile dysfunction, unspecified . 011, Postthrombotic syndrome with ulcer of right lower extremity, and L97. In addition,. The implementation of ICD-10-CM coding brought about significant changes to the world of coding. The etiology code will have a “use additional code” note The manifestation code will have a “code first” note In most cases, “in disease classified elsewhere” will be in the code manifestation title The code title indicates a manifestation code “In diseases classified elsewhere” codes are not to be used as first-listed or. For such conditions the ICD-10-CM has a coding convention that requires the underlying condition. The 7th character must always be the 7th character in the data field. ↓ See below for any exclusions, inclusions or special notations. 0. 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 . These instructional notes indicate the proper sequencing order of the codes, etiology followed by manifestation. detail to ensure the code assignment is not affected. The diagnosis codes (Tabular List and Alphabetic Index) have been adopted under HIPAA for all healthcare settings. 13. Study with Quizlet and memorize flashcards containing terms like When a code does not exist that accurately describes the procedure/treatement, the coder should report an unlisted code. You will also find instructional notes that say code first or use additional 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. -) •Tobacco use (Z72. 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 . provide general information on usage in a specific section. infection. The two codes are to be sequenced as listed in the "Index to Diseases. Your Answer:false An additional codes instructional note is listed under code 33881. Volume 3 procedure codes have been adopted for inpatient. antonyms of code titles or "unspecified" terms. Instructional notes Punctuation marks Abbreviations Symbols Instructional Notes In both the index and tabular. ” 1. These instructional notes indicate the proper sequencing order of the codes, etiology followed by manifestation. Category J05 Use Additional code note and Code Also 9. It consists 1. They may appear independently of each other or to designate certain etiology/manifestation paired codes. E26. 83)ICD 10 Code Description Notes E08. In ICD coding, the code first is not used. Learn your Medical Coding Conventions and Guidelines. In most cases the manifestation codes will have in the code title, "in diseases. initial encounter. 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. 8, B96. 890 is a valid billable ICD-10 diagnosis code for Other specified postprocedural states . appears in the Tabular NOS means not otherwise specified. underlying disease, such as: amyloidosis E85Question options: 1 / 1 point What additional code(s) are we advised to use?. Some categories of codes (e. K90. 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. 7th Character Certain ICD-10-CM categories have applicable 7th characters. 15. 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. R11. The “code first” note appears in the Tabular List under the. The ICD-10-CM code assigned to this case is:Instructional notes are an important resource for medical coders, as they provide additional guidance and clarification when the code descriptions in the Tabular section of the coding book are not clear or specific enough. 20. 10 is a valid billable ICD-10 diagnosis code for Social phobia, unspecified . 80 d. 4-I51. Combination codes would be reported for these. 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. F33. " In the "Index to Diseases," the multiple coding requirement is. E11. Verified answer. 850. 20 is assigned a tthe direction of the "use additional code to identify alcohol use and dependence (F10. 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. 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 . 0) is reported as the PDX followed by the code for the heart failure (I50. R91. A) when the note appears under a code, it is acceptable to use both the code and the excluded code together when applicable. These instructional notes indicate the proper sequencing order of the codes, etiology followed by manifestation. The diagnosis codes (Tabular List and Alphabetic Index) have been adopted under HIPAA for all healthcare settings. True. An instructional note in ICD-10-CM for intellectual disabilities (F70 through F79) directs coders to: a. Select one: a. After work-up it was determined that he has a benign neoplasm of the temporal lobe of his brain. These instructional notes indicate the proper sequencing order of the codes, etiology followed by manifestation. R14. It is used in the alphabetical Index of ICD-10-CM and instructs the coder that another term should be referenced. 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 Drug or chemical-induced diabetes mellitus Code first a dx from (T36-T65) Use additional code for adverse effect (T36-T50) E10. There is an instructional note use additional code to identify organism. 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. true false Modifiers are used to identify when no procedure is done. that it is a pure excludes note. Notice the instructional notes tell the coder to assign a code for diabetes first (code first any associated diabetic chronic kidney disease). 9 is a valid billable ICD-10 diagnosis code for Acute upper respiratory infection, unspecified . It instructs you to code first underlying disease, which in this case, is the cirrhosis of the liver from the alcohol. Patient is admitted to the hospital with pneumonia due to bacteriodes fragilis, J15. – The manifestation codes usually have the phrase “ in diseases classified elsewhere” as part of the code title. appearing. -)" instructional note under category K70. E66. CMS. ( True/False) Question 2. These instructional notes indicate the proper sequencing order of the codes, etiology followed by manifestation. B) the condition excluded is not part of the condition represented by the code, but a patient may have both conditions at the same time. These instructional notes indicate the proper sequencing order of the codes, etiology followed by manifestation. b. These instructional notes indicate that the etiology code should be listed first followed by the manifestation code. 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. d. Correctly use instructional terms and symbols as defined in the ICD-9-CM. 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. A. None of these codes. ICD-10-CM Tabular Instructional Notes . Best answers. The instructional note “Use additional code, where applicable, to identify exposure to environmental tobacco smoke (Z77. The "use additional code" note will be found under the associated condition code in the "Tabular List of Diseases. appears in the Tabular NOS means not otherwise specified. –In the index both conditions are listed together with the. Inclusion notes. K62. 4 , N18. Patient has type 2 DM with diabetes-related CKD stage 3. These instructional notes indicate the proper sequencing order of the codes, etiology followed by manifestation. Largo, FL. These instructional notes indicate the proper sequencing order of the codes: etiology, followed by manifestation. 4-)Study with Quizlet and memorize flashcards containing terms like These _____ are incorporated within the Alphabetic Index and Tabular List of the ICD--CM as instructional notes, The conventions and instructions of the classification take precedence over _____, The _____ _____ is an alphabetical list of terms and their corresponding code. 42 is a valid billable ICD-10 diagnosis code for Type 2 diabetes mellitus with diabetic polyneuropathy . In most cases, the manifestation codes will have in the code title, “in. In the following problem, find polar and Cartesian forms for all three cube roots of the complex number. 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. Fully searchable through Find-A-Code's Comprehensive Search. 9, C37) explicitly indicate the use of additional codes to identify exposures and histories. 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. Verified answer. This is where you may see a “Use additional” note, or a note that states “Code first”. Instructional notes appear in both the Tabular List and Alphabetic Index of ICD-10-CM. These instructional notes indicate that the etiology code should be listed first followed by the manifestation code. You are directed to R11. 9 (sepsis, unspecified organism) with T81. 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. 1 - N18. Hypertension With Heart Disease. Wherever such a combination exists, a Use additional code note is found with the etiology code, and a Code first note is found with the manifestation code. 11 is a valid billable ICD-10 diagnosis code for Chronic respiratory failure with hypoxia . Look at code E10. Manifestation. There is no mention of vomiting. The International Classification of Diseases, 10th Revision, Clinical Modification (ICD-10-CM) is a morbidity classification published by the Centers for Medicare and Medicaid Services. 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. 6). They may appear independently of each other or to designate certain etiology/manifestation paired codes. R50. Relating to Use Additional Code and Code First Instructional Notes: The CODE FIRST note _____. 3 is a valid billable ICD-10 diagnosis code for Pseudocyst of pancreas . 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. 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. 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 . More Coding Conventions. These instructional notes indicate the proper sequencing order of the codes, etiology followed by manifestation. E86. Correct Answer : Add an additional character to the code . Use the code(s) in brackets in addition to the disease or condition to identity an associated manifestation. 8. In ICD-10-CM there are no supplementary classifications. M96. These instructional notes indicate the proper sequencing order of the codes, etiology followed by manifestation. heart involvement. 001. For such codes, there is a “use additional code” note at the etiology code and a “code first” note at the manifestation code and the rules for sequencing apply The Code Also note is used in ICD-10-CM to instruct the coder that two codes may be needed to fully code a diagnostic phrase. 9, are assigned to a code from category I11, Hypertensive heart disease. 22? “Use additional code” to identify stage of chronic kidney disease (N18. Alphabetic Index. 111. 0. F40. NOS. In most cases, the manifestation codes will have in the code title “in diseases classified elsewhere. “These are the ‘code first,’ ‘use additional code,’ and ‘in diseases classified elsewhere’ notes you see in the Tabular section of ICD-10,” Blanchard. Also indicates the etiology code is to be first listed before the manifestation code. The use additional note may need revision to identify the “type” of sepsis (as is seen in the note. 9. ” These scenarios can be confusing. instructional notes. instructional notes. List the instructional. See Note: an instruction following the main term in the Alphabetic Index that indicates that another term should be referenced - for correct coding it is necessary to go to the main term referenced with this note. 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.