Signs and symptoms associated with a disease process should not be assigned additional codes unless otherwise instructed by ICD-10-CM because they are __________.

The correct choice emphasizes that signs and symptoms related to a specific disease are generally captured within the diagnostic code for that disease process itself. This means the underlying condition already encompasses the associated manifestations, so additional codes for those specific symptoms are not necessary unless ICD-10-CM provides instruction otherwise. This approach helps ensure that the coding remains streamlined and avoids redundancy, making it clearer for healthcare providers to understand the patient's clinical picture.

In contrast, the other answer choices suggest different coding practices that do not align with the guidelines in ICD-10-CM. For instance, combination codes refer to codes that include both the condition and associated symptoms, but they are specific to certain diagnoses, not a blanket rule for all cases. The notion of reporting multiple codes would imply a need to separate the signs and symptoms from the primary condition, which is not the case unless specified. Finally, documenting separately indicates a need to have independent codes for signs and symptoms, conflicting with the principle that they are encompassed in the main diagnosis.