S06.385A — Contusion, laceration, and hemorrhage of brainstem with loss of consciousness greater than 24 hours with return to pre-existing conscious level, initial encounter
S06.385A is a billable, specific ICD-10-CM code for contusion, laceration, and hemorrhage of brainstem with loss of consciousness greater than 24 hours with return to pre-existing conscious level, 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
S06.385A 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
S06.385A is named in 12 Medicare coverage policies — 12 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 S06.385. If S06.385A is not quite right, the correct code is usually one of these.
- S06.385DContusion, laceration, and hemorrhage of brainstem with loss of consciousness greater than 24 hours with return to pre-existing conscious level, subsequent encounter
- S06.385SContusion, laceration, and hemorrhage of brainstem with loss of consciousness greater than 24 hours with return to pre-existing conscious level, sequela
Questions about S06.385A
- Is S06.385A a billable ICD-10-CM code?
- Yes. S06.385A is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does S06.385A 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).