S06.323A — Contusion and laceration of left cerebrum with loss of consciousness of 1 hour to 5 hours 59 minutes, initial encounter
S06.323A is a billable, specific ICD-10-CM code for contusion and laceration of left cerebrum 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
S06.323A 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
S06.323A is named in 11 Medicare coverage policies — 11 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
- A56773Billing and Coding: Neurophysiology Evoked Potentials (NEPs)
Related codes at this level
Codes that share S06.323. If S06.323A is not quite right, the correct code is usually one of these.
Questions about S06.323A
- Is S06.323A a billable ICD-10-CM code?
- Yes. S06.323A is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does S06.323A 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).