ICD-9-CM uses “late effect” (sequela) codes to link a residual condition to its original cause. The Official Guidelines for Coding and Reporting state that when an index entry or table does not supply a specific late-effect code, the coder must report only the code that describes the residual condition itself. No additional code for the original injury or illness is assigned because, without an established late-effect code, the linkage between the cause and the residual cannot be expressed in the classification.

A. Requires a late-effect (cause) code that does not exist; sequencing residual first then cause is permitted only when a valid late-effect code is present.

B. Same issue as A; cannot report an etiology code without an accompanying late-effect code.

D. Coding only the cause misrepresents the clinical reason for the encounter, which is the residual condition.

1. Centers for Disease Control and Prevention & National Center for Health Statistics. ICD-9-CM Official Guidelines for Coding and Reporting

2014

Section I.B.15 “Late Effects

” paragraph 4: “If a late effect code is not available

use only the residual condition code.”

2. American Health Information Management Association. “ICD-9-CM Late Effects Guidelines.” Journal of AHIMA 74(3):64–65

2003.

3. Faye Brown’s ICD-9-CM Coding Handbook

2013 ed.

ch. 3 “Late Effects

” p. 3-8: “When no late-effect code exists

report only the residual condition.”