S06.5X4A: Traumatic subdural hemorrhage with loss of consciousness of 6 hours to 24 hours, initial encounter
S06.5X4A is a billable, specific ICD-10-CM code for traumatic subdural hemorrhage with loss of consciousness of 6 hours to 24 hours, initial encounter. It is valid for submission on a claim.
Check S06.5X4A 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 S06.5X4A
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
S06.5X4A 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. Look up the whole chart to see which of its HCCs the hierarchy would zero.
Medicare coverage
S06.5X4A is named in 13 Medicare coverage policies: 13 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
- A56747Billing and Coding: Magnetic Resonance Angiography (MRA)
Code history
Unchanged in every release from FY2024 to FY2027.