Certified Medical Assistant (CMA AAMA)Administrative: Billing, Coding and SchedulingMedium
A medical assistant is abstracting information from a patient's chart for coding. The patient has a documented diagnosis of 'Type 2 diabetes mellitus with diabetic neuropathy.' Which of the following ICD-10-CM coding guidelines applies to this scenario?
- ACode each condition separately without a specific order.
- BCode first the manifestation, then the underlying condition.
- CCode only the most severe condition documented.
- DCode the underlying condition first, followed by the manifestation.
Show answer & explanationAnswer & explanation
Correct answer: D. Code the underlying condition first, followed by the manifestation.
ICD-10-CM official coding guidelines state that when a causal relationship between two conditions (like diabetes and its complications) is documented, the underlying condition (diabetes) should be coded first, followed by the manifestation (neuropathy).
Why the other options are wrong
- A. There are specific sequencing rules for conditions linked by 'with' or 'due to,' not just separate coding.
- B. This is incorrect; for conditions like diabetes with manifestations, the underlying condition is coded first.
- C. While severity is considered, the primary guideline for 'with' conditions is sequencing, not just severity.
ICD-10-CM Etiology/Manifestation Rule
A coding guideline that dictates the sequencing of codes when one condition is caused by another, typically requiring the underlying cause (etiology) to be coded first, followed by the symptom or manifestation.
- Applies when a causal relationship exists (e.g., 'due to', 'with').
- Etiology (underlying condition) is coded first.
- Manifestation (symptom/complication) is coded second.
- Often indicated by 'code first' or 'use additional code' notes in the ICD-10-CM manual.
Memory trick: Etiology/Manifestation: 'E' before 'M', like 'A' before 'B'.