ICD-10 Coding for Concussion with Loss of Consciousness(S06.0X1A, S06.0X2A, S06.0X3A, S06.0X9A)
Complete ICD-10-CM coding and documentation guide for Concussion with Loss of Consciousness. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Concussion with Loss of Consciousness
S06.0XPrimary Range
Concussion
This range includes all codes for concussion with varying durations of loss of consciousness.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| S06.0X1A | Concussion with loss of consciousness of 30 minutes or less, initial encounter | Use when LOC is documented as less than 30 minutes. |
|
| S06.0X2A | Concussion with loss of consciousness of 30 minutes to 24 hours, initial encounter | Use when LOC is documented as between 30 minutes and 24 hours. |
|
| S06.0X3A | Concussion with loss of consciousness of 24 hours or more, initial encounter | Use when LOC is documented as 24 hours or more. |
|
| S06.0X9A | Concussion with loss of consciousness of unspecified duration, initial encounter | Use when LOC is documented but the duration is not specified. |
|
Clinical Decision Support
Always review the patient's clinical documentation thoroughly. When in doubt, choose the more specific code and ensure documentation supports it.
Key Information: ICD-10 code for concussion with loss of consciousness
Essential facts and insights about Concussion with Loss of Consciousness
Primary ICD-10-CM Codes for concussion with loss of consciousness
Decision Criteria
clinical Criteria
- LOC duration less than 30 minutes
Applicable To
- Concussion with brief LOC
Excludes
- Concussion without LOC
Clinical Validation Requirements
- Documented LOC duration less than 30 minutes
- Mechanism of injury
Code-Specific Risks
- Incorrect duration documentation
Coding Notes
- Ensure the duration of LOC is clearly documented to avoid using unspecified codes.
S06.0X2A - Concussion with loss of consciousness of 30 minutes to 24 hours, initial encounter
Use when LOC is documented as between 30 minutes and 24 hours.
Applicable To
- Concussion with moderate LOC
Excludes
- Concussion without LOC
Clinical Validation Requirements
- Documented LOC duration between 30 minutes and 24 hours
- Mechanism of injury
Coding Notes
Ensure the duration of LOC is clearly documented to avoid using unspecified codes.
S06.0X3A - Concussion with loss of consciousness of 24 hours or more, initial encounter
Use when LOC is documented as 24 hours or more.
Applicable To
- Concussion with prolonged LOC
Excludes
- Concussion without LOC
Clinical Validation Requirements
- Documented LOC duration of 24 hours or more
- Mechanism of injury
Coding Notes
Ensure the duration of LOC is clearly documented to avoid using unspecified codes.
S06.0X9A - Concussion with loss of consciousness of unspecified duration, initial encounter
Use when LOC is documented but the duration is not specified.
Applicable To
- Concussion with unknown LOC duration
Excludes
- Concussion without LOC
Clinical Validation Requirements
- LOC occurred but duration not documented
Coding Notes
Query the provider for LOC duration to avoid using unspecified codes.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Struck by football, initial encounter
W21.31XAActivity, football
Y93.63Football field as the place of occurrence
Y92.146Activity, driver
Y93.C1Differential Codes
Alternative codes to consider when ruling out similar conditions to the primary diagnosis.
Concussion without loss of consciousness, initial encounter
S06.0X0AConcussion with loss of consciousness of 30 minutes or less, initial encounter
S06.0X1AConcussion with loss of consciousness of 30 minutes to 24 hours, initial encounter
S06.0X2ADocumentation & Coding Risks
Avoid these common documentation and coding issues when documenting Concussion with Loss of Consciousness to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code S06.0X1A.
Impact
Clinical: Inaccurate clinical records, Regulatory: Increased audit risk, Financial: Potential for reduced reimbursement
Mitigation Strategy
Educate providers on documentation requirements, Implement documentation checklists
Impact
Reimbursement: May lead to lower reimbursement rates., Compliance: Increases risk of audit., Data Quality: Reduces accuracy of health records.
Mitigation Strategy
Ensure documentation specifies LOC duration to use the correct code.
Impact
Reimbursement: Incomplete coding can affect DRG assignment., Compliance: Non-compliance with coding guidelines., Data Quality: Incomplete injury data.
Mitigation Strategy
Always include external cause codes to specify the cause of injury.
Impact
Using unspecified codes when LOC duration is known increases audit risk.
Mitigation Strategy
Ensure documentation includes specific LOC duration.
Documentation errors, coding pitfalls, and audit risks are interconnected aspects of medical coding and billing. Addressing all three areas helps ensure accurate coding, optimal reimbursement, and regulatory compliance.
Frequently Asked Questions
Common questions about ICD-10 coding for Concussion with Loss of Consciousness, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Concussion with Loss of Consciousness
Use these documentation templates to ensure complete and accurate documentation for Concussion with Loss of Consciousness. These templates include all required elements for proper coding and billing.
Emergency Department Visit for Concussion
Specialty: Emergency MedicineRequired Elements
- Patient demographics
- Mechanism of injury
- Duration of LOC
- GCS score
- Imaging results
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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