Unsp focal TBI w LOC of 6 hours to 24 hours, sequela

This code signifies a long-term consequence (sequela) of a focal traumatic brain injury where the patient experienced a loss of consciousness lasting between 6 and 24 hours. "Focal" indicates the injury was localized to a specific area of the brain, rather than diffuse. The "unspecified" nature means the specific type of focal injury (e.g., contusion, laceration) is not documented.

Use this code when documenting residual effects or complications arising from a focal TBI that occurred in the past, where the original injury involved a loss of consciousness for 6 to 24 hours. This applies when the patient is no longer in the acute phase of the injury. Documentation should clearly state the TBI as the cause of the current condition and specify the duration of the initial loss of consciousness.

• Always sequence this sequela code after the code describing the specific residual condition being treated (e.g., cognitive deficits, post-traumatic epilepsy).
• Ensure the medical record explicitly states "sequela" or "late effect" of a TBI, and specifies the duration of the initial loss of consciousness.
• Do not use this code for acute TBI encounters; instead, use the appropriate acute TBI code from the S06 category with the correct seventh character for the initial encounter, subsequent encounter, or sequela.