Traum hemor right cerebrum with LOC status unknown, sequela

This code signifies a traumatic bleeding event within the right cerebral hemisphere, where the patient experienced a loss of consciousness, and the specific duration or nature of that loss is not documented. It indicates that the hemorrhage is a sequela, meaning it is a residual effect or complication of a previous injury.

Apply this code when documentation clearly states a traumatic hemorrhage in the right cerebrum, a history of loss of consciousness, and the encounter is for the long-term effects or complications of this prior injury. This code is appropriate when the initial acute injury has resolved, and the patient is now being treated for the lasting impact of the hemorrhage.

• Ensure documentation explicitly states "sequela" or indicates treatment for residual effects of a past traumatic cerebral hemorrhage.
• Do not use for acute traumatic cerebral hemorrhages; those require codes from the S06.3 series without the "S" seventh character.
• If the specific duration of loss of consciousness is known, a more specific code from the S06.34 series (e.g., S06.34AS, S06.34BS, S06.34CS) should be used.