The code choice is affected tremendously by the ICD Official Guidelines for Coding and Reporting. If you do not follow the coding guidelines you can reportthe incorrect codes. That can turn into a big issue when it comes to reimbursement. The most challenging guideline for me is deciding what 7th character to use, and what they mean. When I come across them I take notes and keep repeating them until it sticks with me. I could definitely use more help in that area! The code choice affected by the reading of the ICD Official Guidelines for coding and reporting is very important because by not following the guidelines you may not end up with the correct code. As discussed in past discussions, it is most important to start your coding by using the 8 steps of accurate coding.