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It depends on documentation specificity: If syncope is due to orthostatic hypotension: I95.1 (principal) + R55 (secondary) If due to drug-induced orthostatic hypotension: I95.2 (principal) + T code for drug + R55 If orthostatic hypotension is mentioned but syncope is not attributed to it: R55 (principal) + I95.1 (secondary) When syncope is documented as due to a cardiac condition, code the cardiac condition as principal diagnosis and R55 as secondary