How should sequelae (late effects) be coded in terms of sequencing?

In coding for sequelae (late effects), it is important to code the sequelae first, followed by the cause. This approach aligns with the guidelines provided in the ICD-10-CM coding manual. When a condition is a sequela of a previous disease or injury, it reflects the ongoing impact or consequence of that initial event.

For instance, if a person has suffered a stroke that resulted in hemiplegia, the hemiplegia (the sequela) is coded first to indicate its direct relevance to the patient's current health status. The original stroke (the cause) is then coded second to clarify the underlying reason for the sequela. This sequencing ensures that the focus is placed on the current impact on the patient’s health, which is key for treatment planning and understanding the patient's medical history.

Understanding this hierarchy in coding is crucial for accurate documentation, billing, and understanding the patient’s condition in the context of healthcare delivery, insurance claims, and data collection.