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One of the light bulbs in Chapter 16 is: The ICD-10-CM code for the diagnosis, condition, problem, or other reason for encounter/visit shown in the medical record to be chiefly responsible for the services provided is reported first, followed by codes for any coexisting conditions. This key point applies to coding because it helps to determine the sequencing of codes and the assignment of the principal diagnosis. The principal diagnosis is defined as the condition established after study to be chiefly responsible for occasioning the admission of the patient to the hospital for care. The sequencing of codes affects the reimbursement and quality measures of health care providers. An example of applying this key point is: A patient is admitted to the hospital with chest pain and shortness of breath. After a series of tests, the patient is diagnosed with acute myocardial infarction and congestive heart failure. The patient receives treatment for both conditions and is discharged after three days. The principal diagnosis in this case is acute myocardial infarction, because it is the condition that necessitated the admission of the patient to the hospital. The code for acute myocardial infarction is I21.9. The secondary diagnosis is congestive heart failure,
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