Wiki Instructional notes

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I am looking for some clarification on some instructional notes in the code book. I'm just trying to get clarification on a few things...
Codes in brackets are part of the etiology/manifestation convention and even in absence of provider documentation, those are to be coded together. Do I understand this correctly? What about "use additional code to identify", "code also" and "use additional code if applicable". I have queried my providers on some of these when I come across them and a lot of the time, they send it back stating the additional codes do not apply. So I don't understand why one says use additional code and one says use additional code if applicable...
 
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