2021 ICD-10-CM Code S06.9X1A
Unspecified intracranial injury with loss of consciousness of 30 minutes or less, initial encounter
Valid for Submission
S06.9X1A is a billable diagnosis code used to specify a medical diagnosis of unspecified intracranial injury with loss of consciousness of 30 minutes or less, initial encounter. The code S06.9X1A is valid during the fiscal year 2021 from October 01, 2020 through September 30, 2021 for the submission of HIPAA-covered transactions.
S06.9X1A is an initial encounter code, includes a 7th character and should be used while the patient is receiving active treatment for a condition like unspecified intracranial injury 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.
Unspecified diagnosis codes like S06.9X1A are acceptable when clinical information is unknown or not available about a particular condition. Although a more specific code is preferable, unspecified codes should be used when such codes most accurately reflect what is known about a patient's condition. Specific diagnosis codes should not be used if not supported by the patient's medical record.
The code S06.9X1A 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.
| ICD-10: | S06.9X1A |
| Short Description: | Unsp intracranial injury w LOC of 30 minutes or less, init |
| Long Description: | Unspecified intracranial injury with loss of consciousness of 30 minutes or less, initial encounter |
Code Classification
Convert S06.9X1A to ICD-9 Code
The General Equivalency Mapping (GEM) crosswalk indicates an approximate mapping between the ICD-10 code S06.9X1A its ICD-9 equivalent. The approximate mapping means there is not an exact match between the ICD-10 code and the ICD-9 code and the mapped code is not a precise representation of the original code.
- 854.02 - Brain inj NEC-brief coma (Approximate Flag)
Quality Payment Program Measures
When code S06.9X1A 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 |
Information for Patients
Traumatic Brain Injury
Also called: Acquired brain injury, TBI
Traumatic brain injury (TBI) happens when a bump, blow, jolt, or other head injury causes damage to the brain. Every year, millions of people in the U.S. suffer brain injuries. More than half are bad enough that people must go to the hospital. The worst injuries can lead to permanent brain damage or death. Half of all TBIs are from motor vehicle accidents. Military personnel in combat zones are also at risk.
Symptoms of a TBI may not appear until days or weeks following the injury. A concussion is the mildest type. It can cause a headache or neck pain, nausea, ringing in the ears, dizziness, and tiredness. People with a moderate or severe TBI may have those, plus other symptoms:
- A headache that gets worse or does not go away
- Repeated vomiting or nausea
- Convulsions or seizures
- Inability to awaken from sleep
- Slurred speech
- Weakness or numbness in the arms and legs
- Dilated eye pupils
Health care professionals use a neurological exam and imaging tests to assess TBI. Serious traumatic brain injuries need emergency treatment. Treatment and outcome depend on how severe the injury is. TBI can cause a wide range of changes affecting thinking, sensation, language, or emotions. TBI can be associated with post-traumatic stress disorder. People with severe injuries usually need rehabilitation.
NIH: National Institute of Neurological Disorders and Stroke
- Brain injury - discharge (Medical Encyclopedia)
- Chronic subdural hematoma (Medical Encyclopedia)
- EEG (Medical Encyclopedia)
- Head injury - first aid (Medical Encyclopedia)
- Intracranial pressure monitoring (Medical Encyclopedia)
- Subdural hematoma (Medical Encyclopedia)
[Learn More in MedlinePlus]
Code History
- 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 (First year ICD-10-CM implemented into the HIPAA code set)