Version 2024

2024 ICD-10-CM Diagnosis Code S06.A1XA

Traumatic brain compression with herniation, initial encounter

ICD-10-CM Code:: S06.A1XA
ICD-10 Code for:: Traumatic brain compression with herniation, init
Is Billable?: Yes - Valid for Submission
Chronic Condition Indicator: ^[1]: Not chronic
Code Navigator:

Code Information
Clinical Classification
Coding Guidelines
Tabular List of Diseases and Injuries
Code Edits
Replacement 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.A1XA is a billable diagnosis code used to specify a medical diagnosis of traumatic brain compression with herniation, 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.

This code describes a circumstance which influences the patient's health status but not a current illness or injury. The code is unacceptable as a principal diagnosis.

S06.A1XA is an initial encounter code, includes a 7th character and should be used while the patient is receiving active treatment for a condition like traumatic brain compression with herniation. 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

Code Edits

The Medicare Code Editor (MCE) detects and reports errors in the coding of claims data. The following ICD-10-CM Code Edits are applicable to this code:

Unacceptable principal diagnosis - There are selected codes that describe a circumstance which influences an individual's health status but not a current illness or injury, or codes that are not specific manifestations but may be due to an underlying cause. These codes are considered unacceptable as a principal diagnosis.

Replacement Code

S06A1XA replaces the following previously assigned ICD-10-CM code(s):

S06.890A - Intcran inj w/o loss of consciousness, init encntr
S06.899A - Intcran inj w loss of consciousness of unsp duration, init

Quality Payment Program Measures

When code S06.A1XA 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

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.
S06.0X1A Concussion with loss of consciousness of 30 minutes or less, initial encounter.
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.

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 - Code Added, effective from 10/1/2021 through 9/30/2022

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.