S06.9X5A — Unspecified intracranial injury with loss of consciousness greater than 24 hours with return to pre-existing conscious level, initial encounter
S06.9X5A is a billable, specific ICD-10-CM code for unspecified intracranial injury 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
Excludes1 inherited from the categories above S06.9X5A
These are not written on S06.9X5A, but they bind it: a note on a category applies to every code beneath it. Billing S06.9X5A with anything listed here is a denial.
Written on S06.9 — Unspecified intracranial injury
Other codes that can never be billed with S06.9X5A
These codes carry an Excludes1 note pointing at S06.9X5A. The conflict binds both ways, but ICD-10-CM only writes it down on one side — so you would not find this by reading S06.9X5A alone.
- 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
- 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
- S09.0XXSInjury of blood vessels of head, not elsewhere classified, sequela
Risk adjustment
S06.9X5A 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
S06.9X5A is named in 9 Medicare coverage policies — 9 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
- A56937Billing and Coding: Psychiatry and Psychology Services
Code history
S06.9X5A has not changed since FY2024 — no addition, revision or deletion across the three most recent ICD-10-CM releases.
Related codes at this level
Codes that share S06.9X5. If S06.9X5A is not quite right, the correct code is usually one of these.
Questions about S06.9X5A
- Is S06.9X5A a billable ICD-10-CM code?
- Yes. S06.9X5A is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does S06.9X5A 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).
- What cannot be coded together with S06.9X5A?
- S06.9X5A carries Excludes1 notes, which means the conditions they list can never be coded together with it on the same encounter. Some are written on the categories above S06.9X5A (S06.9, S06) and apply to it just the same.