# Etiology/Manifestation code



## martyzal (Sep 11, 2009)

I keep reading over this in the coding guidelines page 3  2009 ICD-9 manuel. I am confused on how they want you to code Diabetes with other diagnosis. Does the diabetes dx code go first or does the other illness. For example patient has HBP, headache and diabeties, what order do you code. And does the same go for a patient with hypertension and other diagnosis?


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## mitchellde (Sep 11, 2009)

If the physician documents that the condition is causal then you code the causal(underlying) condition first.  For instance, a diabetic ulcer, is coded as the 250.8x fisrt then the ulcer 707.1x second, hypertensive heart disease is 402.9x, but diabetes with an ulcerative condition is 707.1x and 250.0x, and heart disease with HTN is the heart disease code with 401.9.  So it all depends on how the physician documents the condition.


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