Step-by-step explanation:
When there is a code first note and an underlying condition is present, the underlying condition should be sequenced first. A "code first" note indicates that the underlying condition is the reason for the encounter, and the secondary code represents a manifestation or complication of that condition. Therefore, it is important to sequence the underlying condition first to accurately reflect the reason for the encounter.
For example, if a patient with diabetes mellitus (DM) presents with a foot ulcer, the appropriate sequencing would be to list DM as the primary diagnosis followed by the foot ulcer as a secondary diagnosis. This is because the foot ulcer is a manifestation of the patient's DM.
It is important to note that not all notes will have a "code first" instruction. In these cases, it is still important to accurately sequence diagnoses based on their clinical significance and relationship to the encounter.
In summary, when there is a code first note and an underlying condition is present, the underlying condition should be sequenced first to accurately reflect the reason for the encounter.