Version 2024

2024 ICD-10-CM Diagnosis Code S06.0X1A

Concussion with loss of consciousness of 30 minutes or less, initial encounter

ICD-10-CM Code:: S06.0X1A
ICD-10 Code for:: Concussion w LOC of 30 minutes or less, init
Is Billable?: Yes - Valid for Submission
Chronic Condition Indicator: ^[1]: Not chronic
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Code Information
Clinical Classification
Coding Guidelines
Tabular List of Diseases and Injuries
Convert to ICD-9 Code
Quality Payment Program Measures
Patient Education
Other Codes Used Similar Conditions
Code History

Code Classification

Injury, poisoning and certain other consequences of external causes
(S00–T88)
- Injuries to the head
  (S00-S09)
  - Intracranial injury
    (S06)

S06.0X1A is a billable diagnosis code used to specify a medical diagnosis of concussion with loss of consciousness of 30 minutes or less, 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.

S06.0X1A is an initial encounter code, includes a 7th character and should be used while the patient is receiving active treatment for a condition like concussion with loss of consciousness of 30 minutes or less. 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 Traumatic brain injury (TBI); concussion, initial encounter
CCSR Category Code: INJ008
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 Intracranial injury (S06). Use the following options for the aplicable episode of care:

A - initial encounter
D - subsequent encounter
S - sequela

Convert S06.0X1A to ICD-9-CM

ICD-9-CM Code: 850.11 - Concus-brief coma <31 mn
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 S06.0X1A 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

Concussion

A concussion is a type of brain injury. It involves a short loss of normal brain function. It happens when a hit to the head or body causes your head and brain to move rapidly back and forth. This sudden movement can cause the brain to bounce around or twist in the skull, creating chemical changes in your brain. Sometimes it can also stretch and damage your brain cells.

Sometimes people call a concussion a "mild" brain injury. It is important to understand that while concussions may not be life-threatening, they can still be serious.

Concussions are a common type of sports injury. Other causes of concussions include blows to the head, bumping your head when you fall, being violently shaken, and car accidents.

Symptoms of a concussion may not start right away; they may start days or weeks after the injury. Symptoms may include a headache or neck pain. You may also have nausea, ringing in your ears, dizziness, or tiredness. You may feel dazed or not your normal self for several days or weeks after the injury. Consult your health care professional if any of your symptoms get worse, or if you have more serious symptoms such as:

Convulsions or seizures
Drowsiness or inability to wake up
A headache that gets worse and does not go away
Weakness, numbness, or decreased coordination
Repeated vomiting or nausea
Confusion
Slurred speech
Loss of consciousness

To diagnose a concussion, your health care provider will do a physical exam and will ask about your injury. You will most likely have a neurological exam, which checks your vision, balance, coordination, and reflexes. Your health care provider may also evaluate your memory and thinking. In some cases, you may also have a scan of the brain, such as a CT scan or an MRI. A scan can check for bleeding or inflammation in the brain, as well as a skull fracture (break in the skull).

Most people recover fully after a concussion, but it can take some time. Rest is very important after a concussion because it helps the brain to heal. In the very beginning, you may need to limit physical activities or activities that involve a lot of concentration, such as studying, working on the computer, or playing video games. Doing these may cause concussion symptoms (such as headache or tiredness) to come back or get worse. Then when your health care provider says that it is ok, you can start to return to your normal activities slowly.

Centers for Disease Control and Prevention

[Learn More in MedlinePlus]

Other ICD-10-CM Codes Commonly Used for Similar Conditions

Filter related codes list:

S06 Intracranial injury.
S06.0 Concussion.
S06.0X Concussion.
S06.0X0 Concussion without loss of consciousness.
S06.0X0A Concussion without loss of consciousness, initial encounter.
S06.0X0D Concussion without loss of consciousness, subsequent encounter.
S06.0X0S Concussion without loss of consciousness, sequela.
S06.0X1 Concussion with loss of consciousness of 30 minutes or less.
S06.0X1D Concussion with loss of consciousness of 30 minutes or less, subsequent encounter.
S06.0X1S Concussion with loss of consciousness of 30 minutes or less, sequela.
S06.0X9 Concussion with loss of consciousness of unspecified duration.
S06.0X9A Concussion with loss of consciousness of unspecified duration, initial encounter.
S06.0X9D Concussion with loss of consciousness of unspecified duration, subsequent encounter.
S06.0X9S Concussion with loss of consciousness of unspecified duration, sequela.
S06.0XA Concussion with loss of consciousness status unknown.
S06.0XAA Concussion with loss of consciousness status unknown, initial encounter.
S06.0XAD Concussion with loss of consciousness status unknown, subsequent encounter.
S06.0XAS Concussion with loss of consciousness status unknown, sequela.
S06.1 Traumatic cerebral edema.
S06.1X Traumatic cerebral edema.
S06.1X0 Traumatic cerebral edema without loss of consciousness.
S06.1X0A Traumatic cerebral edema without loss of consciousness, initial encounter.
S06.1X0D Traumatic cerebral edema without loss of consciousness, subsequent encounter.
S06.1X0S Traumatic cerebral edema without loss of consciousness, sequela.
S06.1X1 Traumatic cerebral edema with loss of consciousness of 30 minutes or less.
S06.1X1A Traumatic cerebral edema with loss of consciousness of 30 minutes or less, initial encounter.
S06.1X1D Traumatic cerebral edema with loss of consciousness of 30 minutes or less, subsequent encounter.
S06.1X1S Traumatic cerebral edema with loss of consciousness of 30 minutes or less, sequela.
S06.1X2 Traumatic cerebral edema with loss of consciousness of 31 minutes to 59 minutes.
S06.1X2A Traumatic cerebral edema with loss of consciousness of 31 minutes to 59 minutes, initial encounter.
S06.1X2D Traumatic cerebral edema with loss of consciousness of 31 minutes to 59 minutes, subsequent encounter.
S06.1X2S Traumatic cerebral edema with loss of consciousness of 31 minutes to 59 minutes, sequela.
S06.1X3 Traumatic cerebral edema with loss of consciousness of 1 hour to 5 hours 59 minutes.
S06.1X3A Traumatic cerebral edema with loss of consciousness of 1 hour to 5 hours 59 minutes, initial encounter.
S06.1X3D Traumatic cerebral edema with loss of consciousness of 1 hour to 5 hours 59 minutes, subsequent encounter.
S06.1X3S Traumatic cerebral edema with loss of consciousness of 1 hour to 5 hours 59 minutes, sequela.
S06.1X4 Traumatic cerebral edema with loss of consciousness of 6 hours to 24 hours.
S06.1X4A Traumatic cerebral edema with loss of consciousness of 6 hours to 24 hours, initial encounter.
S06.1X4D Traumatic cerebral edema with loss of consciousness of 6 hours to 24 hours, subsequent encounter.
S06.1X4S Traumatic cerebral edema with loss of consciousness of 6 hours to 24 hours, sequela.
S06.1X5 Traumatic cerebral edema with loss of consciousness greater than 24 hours with return to pre-existing conscious level.
S06.1X5A Traumatic cerebral edema with loss of consciousness greater than 24 hours with return to pre-existing conscious level, initial encounter.
S06.1X5D Traumatic cerebral edema with loss of consciousness greater than 24 hours with return to pre-existing conscious level, subsequent encounter.
S06.1X5S Traumatic cerebral edema with loss of consciousness greater than 24 hours with return to pre-existing conscious level, sequela.
S06.1X6 Traumatic cerebral edema with loss of consciousness greater than 24 hours without return to pre-existing conscious level with patient surviving.
S06.1X6A Traumatic cerebral edema with loss of consciousness greater than 24 hours without return to pre-existing conscious level with patient surviving, initial encounter.
S06.1X6D Traumatic cerebral edema with loss of consciousness greater than 24 hours without return to pre-existing conscious level with patient surviving, subsequent encounter.
S06.1X6S Traumatic cerebral edema with loss of consciousness greater than 24 hours without return to pre-existing conscious level with patient surviving, sequela.
S06.1X7 Traumatic cerebral edema with loss of consciousness of any duration with death due to brain injury prior to regaining consciousness.
S06.1X7A Traumatic cerebral edema with loss of consciousness of any duration with death due to brain injury prior to regaining consciousness, initial encounter.
S06.1X8 Traumatic cerebral edema with loss of consciousness of any duration with death due to other cause prior to regaining consciousness.

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.