S06.1X3A — Traumatic cerebral edema with loss of consciousness of 1 hour to 5 hours 59 minutes, initial encounter
S06.1X3A is a billable, specific ICD-10-CM code for traumatic cerebral edema with loss of consciousness of 1 hour to 5 hours 59 minutes, initial encounter. It is valid for submission on a claim.
7th character "A" — initial encounter
The appropriate 7th character is to be added to each code from category S06, except as noted below
- A
- initial encounter
- D
- subsequent encounter
- S
- sequela
Risk adjustment
S06.1X3A risk-adjusts. Under the CMS-HCC V28 model it maps to this category:
- HCC 397 Major Head Injury with Loss of Consciousness > 1 Hour0.199 RAF
Coefficient shown for the Community Non-dual Aged segment. A higher HCC in the same hierarchy will suppress this one, so capturing it does not always add score.
Medicare coverage
S06.1X3A is named in 13 Medicare coverage policies — 13 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.
- A54111Billing and Coding: Speech Language Pathology (SLP) Services: Communication Disorders
- A56537Billing and Coding: Scanning Computerized Ophthalmic Diagnostic Imaging (SCODI)
- A56612Billing and Coding: CT of the Head
- A56631Billing and Coding: Thoracic Aortography and Carotid, Vertebral, and Subclavian Angiography
Related codes at this level
Codes that share S06.1X3. If S06.1X3A is not quite right, the correct code is usually one of these.
Questions about S06.1X3A
- Is S06.1X3A a billable ICD-10-CM code?
- Yes. S06.1X3A is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does S06.1X3A sit in the tabular list?
- Injury, poisoning and certain other consequences of external causes (S00-T88), in the block Injuries to the head (S00-S09).