2024 ICD-10-CM Diagnosis Code S09.19XA
Other specified injury of muscle and tendon of head, initial encounter
- ICD-10-CM Code:
- S09.19XA
- ICD-10 Code for:
- Oth injury of muscle and tendon of head, init encntr
- Is Billable?
- Yes - Valid for Submission
- Chronic Condition Indicator: [1]
- Not chronic
- Code Navigator:
S09.19XA is a billable diagnosis code used to specify a medical diagnosis of other specified injury of muscle and tendon of head, initial encounter. The code is valid during the current fiscal year for the submission of HIPAA-covered transactions from October 01, 2023 through September 30, 2024.
S09.19XA is an initial encounter code, includes a 7th character and should be used while the patient is receiving active treatment for a condition like other specified injury of muscle and tendon of head. According to ICD-10-CM Guidelines an "initial encounter" doesn't necessarily means "initial visit". The 7th character should be used when the patient is undergoing active treatment regardless if new or different providers saw the patient over the course of a treatment. The appropriate 7th character codes should also be used even if the patient delayed seeking treatment for a condition.
The code is linked to some Quality Measures as part of Medicare's Quality Payment Program (QPP). When this code is used as part of a patient's medical record the following Quality Measures might apply: Emergency Medicine: Emergency Department Utilization Of Ct For Minor Blunt Head Trauma For Patients Aged 2 Through 17 Years.
Clinical Classification
Clinical Category is Injury to nerves, muscles and tendons, initial encounter
- CCSR Category Code: INJ025
- Inpatient Default CCSR: Y - Yes, default inpatient assignment for principal diagnosis or first-listed diagnosis.
- Outpatient Default CCSR: Y - Yes, default outpatient assignment for principal diagnosis or first-listed diagnosis.
Coding Guidelines
The appropriate 7th character is to be added to each code from block Other and unspecified injuries of head (S09). Use the following options for the aplicable episode of care:
- A - initial encounter
- D - subsequent encounter
- S - sequela
Convert S09.19XA to ICD-9-CM
- ICD-9-CM Code: 959.01 - Head injury NOS
Approximate Flag - The approximate mapping means there is not an exact match between the ICD-10 and ICD-9 codes and the mapped code is not a precise representation of the original code.
Quality Payment Program Measures
When code S09.19XA is part of the patient's diagnoses the following Quality Measures apply and affect reimbursement. The objective of Medicare's Quality Measures is to improve patient care by making it more: effective, safe, efficient, patient-centered and equitable.
| Quality Measure | Description | Quality Domain | Measure Type | High Priority | Submission Methods |
|---|---|---|---|---|---|
| Emergency Medicine: Emergency Department Utilization of CT for Minor Blunt Head Trauma for Patients Aged 2 Through 17 Years | Percentage of emergency department visits for patients aged 2 through 17 years who presented with a minor blunt head trauma who had a head CT for trauma ordered by an emergency care provider who are classified as low risk according to the Pediatric Emergency Care Applied Research Network (PECARN) prediction rules for traumatic brain injury. | Efficiency and Cost Reduction | Efficiency | YES | Claims, Registry |
Patient Education
Head Injuries
Chances are you've bumped your head before. Often, the injury is minor because your skull is hard and it protects your brain. But other head injuries can be more severe, such as a skull fracture, concussion, or traumatic brain injury.
Head injuries can be open or closed. A closed injury does not break through the skull. With an open, or penetrating, injury, an object pierces the skull and enters the brain. Closed injuries are not always less severe than open injuries.
Some common causes of head injuries are falls, motor vehicle accidents, violence, and sports injuries.
It is important to know the warning signs of a moderate or severe head injury. Get help immediately if the injured person has:
- A headache that gets worse or does not go away
- Repeated vomiting or nausea
- Convulsions or seizures
- An inability to wake up
- Dilated (enlarged) pupil in one or both eyes
- Slurred speech
- Weakness or numbness in the arms or legs
- Loss of coordination
- Increased confusion, restlessness, or agitation
Doctors use a neurologic exam and imaging tests to make a diagnosis. Treatment depends on the type of injury and how severe it is.
NIH: National Institute of Neurological Disorders and Stroke
[Learn More in MedlinePlus]
Muscle Disorders
Your muscles help you move and help your body work. Different types of muscles have different jobs. There are many problems that can affect muscles. Muscle disorders can cause weakness, pain or even paralysis.
Causes of muscle disorders include:
- Injury or overuse, such as sprains or strains, cramps or tendinitis
- A genetic disorder, such as muscular dystrophy
- Some cancers
- Inflammation, such as myositis
- Diseases of nerves that affect muscles
- Infections
- Certain medicines
Sometimes the cause of muscle disorders is unknown.
[Learn More in MedlinePlus]
Code History
- FY 2024 - No Change, effective from 10/1/2023 through 9/30/2024
- FY 2023 - No Change, effective from 10/1/2022 through 9/30/2023
- FY 2022 - No Change, effective from 10/1/2021 through 9/30/2022
- FY 2021 - No Change, effective from 10/1/2020 through 9/30/2021
- FY 2020 - No Change, effective from 10/1/2019 through 9/30/2020
- FY 2019 - No Change, effective from 10/1/2018 through 9/30/2019
- FY 2018 - No Change, effective from 10/1/2017 through 9/30/2018
- FY 2017 - No Change, effective from 10/1/2016 through 9/30/2017
- FY 2016 - New Code, effective from 10/1/2015 through 9/30/2016. This was the first year ICD-10-CM was implemented into the HIPAA code set.
Footnotes
[1] Not chronic - A diagnosis code that does not fit the criteria for chronic condition (duration, ongoing medical treatment, and limitations) is considered not chronic. Some codes designated as not chronic are acute conditions. Other diagnosis codes that indicate a possible chronic condition, but for which the duration of the illness is not specified in the code description (i.e., we do not know the condition has lasted 12 months or longer) also are considered not chronic.