S06.4X9A: Epidural hemorrhage with loss of consciousness of unspecified duration, initial encounter
S06.4X9A is a billable, specific ICD-10-CM code for epidural hemorrhage with loss of consciousness of unspecified duration, initial encounter. It is valid for submission on a claim.
Check S06.4X9A with the rest of the claim: free scrubber7th 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
Other codes that can never be billed with S06.4X9A
Their own Excludes1 notes name this code, so the conflict is not listed above.
- G31.84Mild cognitive impairment of uncertain or unknown etiology
- I69Sequelae of cerebrovascular disease
- I69.8Sequelae of other cerebrovascular diseases
- I69.9Sequelae of unspecified cerebrovascular diseases
- P52Intracranial nontraumatic hemorrhage of newborn
- S09.0Injury of blood vessels of head, not elsewhere classified
- S09.0XXAInjury of blood vessels of head, not elsewhere classified, initial encounter
- S09.0XXDInjury of blood vessels of head, not elsewhere classified, subsequent encounter
Risk adjustment
S06.4X9A risk-adjusts. Under the CMS-HCC V28 model it maps to this category:
- HCC 398 Major Head Injury with Loss of Consciousness < 1 Hour or Unspecified0.199 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. Look up the whole chart to see which of its HCCs the hierarchy would zero.
Medicare coverage
S06.4X9A is named in 11 Medicare coverage policies: 11 listing it as supporting medical necessity. Which one applies depends on your Medicare contractor.
- 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
- A56805Billing and Coding: Magnetic Resonance Angiography (MRA)
Code history
Unchanged in every release from FY2024 to FY2027.