The key point

The Alphabetic Index points you toward a code. The Tabular List is where you verify the complete assignment and its instructions.

Start with the documented term

Choose the main term that represents the documented diagnosis or reason for the encounter. Follow the relevant subterms instead of stopping at the first familiar phrase. An index entry can lead to a category that still needs additional characters.

Search is useful for navigating, but a ranked result is not a code-selection instruction. Open the Alphabetic Index to see the term in context. ICD Code Hub also provides the external-cause index, drug table and neoplasm table.

Source: FY2027 official guidelines: I.A.5 and I.A.16

Follow the index directions

Pay attention to “see” and “see also” references. “See” directs you to another term that must be consulted. “See also” points to another entry that may add useful information; it is not necessary to follow it when the original entry already provides the needed code.

A dash after an index code indicates that more characters are needed. Even without a dash, verify the entry in the Tabular List rather than assuming it is complete.

Source: FY2027 official guidelines: I.A.5 and I.A.16

Verify the code and its parents

Open the full code page, then read the instructions attached to its chapter, block and category as applicable. Inherited instructions can matter even when the individual code has no note of its own. Check the description, laterality, exclusions, sequencing directions and any required seventh character.

For example, M54.5 is a starting point in a hierarchy, while its children provide more detailed entries. Comparing the category and its children shows why a broad search result should not end the lookup.

Source: FY2027 official guidelines: I.A.5 and I.A.16

Make the result easy to review

Keep the chosen code, release and relevant instructions together. The breadcrumb on each Code Hub reference page lets you return to a parent category; the index-term links let you revisit the lookup path. These are useful review steps before a code is copied into another workflow.

If a note is unfamiliar, continue with Excludes1 versus Excludes2. If characters are missing, read the guide to seventh characters and placeholder X.

Sources & editorial notes

  1. FY2027 official guidelines: I.A.5 and I.A.16
  2. FY2027 official guidelines: I.B.1

Based on the FY2027 release. Educational reference content, prepared with AI assistance; not independently reviewed by a credentialed clinical coding specialist. Verify the official instructions and the applicable documentation before assigning codes. Our editorial approach.

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