In what scenario is diabetes reported as a secondary manifestation?

Diabetes is reported as a secondary manifestation when it plays a role in a patient's medical situation but is not the primary reason for an encounter or treatment. In the scenario where an orthopedic surgeon treats a diabetic patient for a hip fracture, diabetes impacts the patient's overall health and may influence the treatment plan, such as considerations for healing, infection risk, and anesthesia. However, the primary diagnosis here is the hip fracture. Therefore, diabetes acts as a secondary condition that is relevant to the patient's care but not the reason for the visit or the main focus of treatment.

This concept helps coders understand the hierarchy of diagnoses and ensures that the coding reflects the primary condition driving the medical necessity while acknowledging any relevant secondary conditions that may complicate the clinical picture.