I believe as per coding guidelines, we should not code signs and symptoms (S&S) along with a code of disease responsible for those S&S, but if we have a proper diagnosis with the responsible disease, that should be coded as 'Code first' scenario. Here in the given example, priapism should be coded as it is a proper disease in itself, but it should be coded after sickle cell crisis as primary dx. In example of pleural effusion, it is considered a S&S, therefore should not be coded if clearly documented as a result of CHF.
It's my opinion, others' advice is welcome.
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