a. Parentheses ( ( ) ). Used to enclose supplementary words that may or may
not be stated as part of the physician's diagnosis/ procedure, and that do not change
the appropriate code.
Hypophosphatemia (acquired) (congenital)
b. Square brackets ( [ ] ). Used to enclose synonyms, alternate wording, or
explanatory phrases or reference assignable 5th digit specificity. Square brackets are
also used to give you an additional code that is needed code.
EXAMPLE: 50.1 Diagnostic procedures on liver
50.11 Percutaneous [needle] biopsy of liver
Diagnostic aspiration of liver
c. Colons (:). Indicates an incomplete term or phrase that must have one of the
modifiers (which follow) in order to make it assignable to the specific category.
EXAMPLE: 491.1 Mucopurulent chronic bronchitis
Bronchitis (chronic) (recurrent):
d. Braces ( } ). Used to connect a series of words to a common term.
EXAMPLE: 250.1 Diabetes with ketoacidosis ;
ketosis } without mention of coma