Diffuse TBI w LOC >24 hr w/o ret consc w surv, sequela

This code signifies a severe, widespread traumatic brain injury where the patient experienced a loss of consciousness exceeding 24 hours. Crucially, the patient did not regain their pre-injury level of consciousness and survived the initial injury, now presenting with long-term effects. This indicates a significant and lasting neurological deficit resulting from the trauma.

Apply this code for patients who have sustained a diffuse TBI with documented unconsciousness lasting over 24 hours, and whose current neurological status demonstrates a persistent impairment compared to their baseline prior to the injury. Documentation must clearly state the duration of unconsciousness and the lack of return to pre-existing conscious level, along with evidence of sequelae.

• Ensure documentation explicitly states "diffuse" TBI and "loss of consciousness greater than 24 hours."
• Verify that the patient's current condition reflects sequelae, indicating a permanent or long-term effect of the injury.
• This code is for use on subsequent encounters for the sequelae of the injury, not for the initial acute injury.