Cracking the Code

Etiology Followed By Manifestation

It is important for coders to remember this rule of thumb: etiology followed by manifestation. Coders are instructed by the coding guidelines to sequence the underlying condition first as the primary diagnosis (if applicable) followed by the manifestation. It is proper protocol for coders to follow the “use additional code” noted under the etiology code and the “code first” code noted under the manifestation code. These instructional notes were created to ensure that there is proper sequencing order of the diagnosis codes: etiology followed by manifestation. Think of it as a dream you want to manifest. The dream/desire/need is created first and then you follow that with manifesting it into your life.

Reference: References: ICD-10-CM Official Guidelines for Coding and Reporting FY 2021 Section I.A.13.
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