S06.325S — Contusion and laceration of left cerebrum with loss of consciousness greater than 24 hours with return to pre-existing conscious level, sequela
S06.325S is a billable, specific ICD-10-CM code for contusion and laceration of left cerebrum with loss of consciousness greater than 24 hours with return to pre-existing conscious level, sequela. It is valid for submission on a claim.
7th character "S" — sequela
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
S06.325S does not map to an HCC and does not risk-adjust under CMS-HCC V28. That is normal — most ICD-10 codes do not. It still needs to be coded correctly; it just will not move a RAF score.
Medicare coverage
S06.325S is named in 14 Medicare coverage policies — 14 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.
- A53057Billing and Coding: Home Health Occupational Therapy
- A53064Billing and Coding: Outpatient Occupational Therapy
- A53065Billing and Coding: Outpatient Physical Therapy
- A54111Billing and Coding: Speech Language Pathology (SLP) Services: Communication Disorders
Related codes at this level
Codes that share S06.325. If S06.325S is not quite right, the correct code is usually one of these.
- S06.325AContusion and laceration of left cerebrum with loss of consciousness greater than 24 hours with return to pre-existing conscious level, initial encounter
- S06.325DContusion and laceration of left cerebrum with loss of consciousness greater than 24 hours with return to pre-existing conscious level, subsequent encounter
Questions about S06.325S
- Is S06.325S a billable ICD-10-CM code?
- Yes. S06.325S is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does S06.325S 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).