2026 ICD-10-CM Diagnosis Code S06.304AUnspecified focal traumatic brain injury with loss of consciousness of 6 hours to 24 hours, initial encounter
S06.304A is a billable ICD-10-CM diagnosis code for unspecified focal traumatic brain injury with loss of consciousness of 6 hours to 24 hours, initial encounter. The 7th character A marks it as an initial encounter code, used while the patient is receiving active treatment. It is valid on HIPAA claims for fiscal year 2026 (October 1, 2025 through September 30, 2026) and groups to MS-DRG 963 through 965. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Traumatic brain injury (TBI); concussion, initial encounter.
Code Identity
Code Classification
Coding GuidelinesGuidance
The appropriate 7th character is to be added to each code from block Intracranial injury (S06). Use the following options for the applicable episode of care:
- A - initial encounter
- D - subsequent encounter
- S - sequela
Source: ICD-10-CM Official Guidelines for Coding and Reporting, FY 2026, published by CMS and the National Center for Health Statistics.
Clinical ClassificationClinical
AHRQ’s CCSR groups this code into broader clinical categories.
Patient EducationClinical
Traumatic Brain Injury
Traumatic brain injury (TBI) is a sudden injury that causes damage to the brain. It may happen when there is a blow, bump, or jolt to the head. This is a closed head injury. A TBI can also happen when an object penetrates the skull. This is a penetrating injury.
The full article covers:
- What is traumatic brain injury (TBI)?
- What causes traumatic brain injury (TBI)?
- Who is at risk for traumatic brain injury (TBI)?
- What are the symptoms of traumatic brain injury (TBI)?
- How is traumatic brain injury (TBI) diagnosed?
- What are the treatments for traumatic brain injury (TBI)?
- Can traumatic brain injury (TBI) be prevented?
Read the full article at MedlinePlus
Courtesy of MedlinePlus, a service of the U.S. National Library of Medicine.
Convert S06.304A to ICD-9-CMHistory
The closest ICD-9-CM equivalents under the General Equivalence Mappings.
Code HistoryHistory
Questions About S06.304AOverview
Is S06.304A a billable code?
Yes. This is a billable ICD-10-CM code, specific enough to report unspecified focal traumatic brain injury with loss of consciousness of 6 hours to 24 hours, initial encounter on HIPAA-covered claims from October 1, 2025 through September 30, 2026.
What does the 7th character A in S06.304A mean?
The final character A marks the initial encounter: use it while the patient is receiving active treatment for unspecified focal traumatic brain injury with loss of consciousness of 6 hours to 24 hours, such as an emergency visit or first evaluation.
What MS-DRG does S06.304A group to?
When unspecified focal traumatic brain injury with loss of consciousness of 6 hours to 24 hours, initial encounter is the principal diagnosis on an inpatient stay, it groups to MS-DRG 963, 964, 965, with relative weights from 0.9405 to 2.7338 depending on complications. Higher weights mean higher Medicare reimbursement.
What is the ICD-9 equivalent of S06.304A?
Under the General Equivalence Mappings, unspecified focal traumatic brain injury with loss of consciousness of 6 hours to 24 hours, initial encounter converts to ICD-9-CM 854.03 (brain inj NEC-mod coma). The mapping is approximate, so confirm the match fits the documentation.
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.
