Cracking the Code
Principal Diagnosis Guidelines – Two Interrelated Conditions
Direct guidance from the coding guidelines state that either condition may be sequenced first when two or more interrelated conditions potentially meet the definition of principal diagnosis. The interrelated conditions refer to diseases in the same ICD-10-CM chapter or manifestations characteristically associated with a certain disease. The ONLY exception to this rule is when the circumstances of the admission, the therapy provided, the Tabular List, or the Alphabetic Index indicate otherwise. If there are no chapter-specific guidelines or instructional notes under the code description for sequencing, then either condition can be listed as the primary diagnosis.