ICD Code S06.5-

ICD code S06.5- is traumatic subdural hemorrhage, which refers to bleeding between the brain surface and the dura mater (the brain’s outer covering) caused by an injury.

1. Patient presents with a history of head trauma.

2. Clinical evaluation reveals a period of loss of consciousness.

3. Duration of loss of consciousness is documented and falls within a specified time frame (e.g., less than 30 minutes, 30 minutes to 24 hours, or more than 24 hours).

4. Neurological examination may show confusion, disorientation, or amnesia related to the event.

5. Imaging studies (such as CT or MRI) may be performed to rule out other intracranial injuries.

6. No evidence of open wound or penetration of the skull.

7. Symptoms may include headache, dizziness, nausea, vomiting, or transient neurological deficits.

8. The condition is not attributable to intoxication, metabolic disorders, or other non-traumatic causes.

Relevant CPT codes that may be used to treat ICD code S06.5- include:

- 99221–99223 (Initial hospital care)

- 99231–99233 (Subsequent hospital care)

- 99291–99292 (Critical care services)

- 61312–61315 (Craniectomy or craniotomy for evacuation)

- 61154 (Burr hole(s) for evacuation)

- 70450, 70460, 70470 (CT scan, head/brain)

- 70551–70553 (MRI, brain)

- 96365–96368 (IV infusion therapy)

- 31500 (Intubation, emergency airway management)

CPT code selection should be based on the specific clinical scenario and services rendered for ICD code S06.5-.

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