Menu
397 HCC

Major Head Injury with Loss of Consciousness > 1 Hour

CMS Model V28 76 Associated ICD-10 Diagnoses

Relative Risk Score Factors (Coefficients for HCC 397)

Enrollment Model Type Coeff Tag Year Weight Score
CFA HCC397 2026 + 0.349
CFD HCC397 2026 + 0.190
CNA HCC397 2026 + 0.199
CND HCC397 2026 + 0.150
CPA HCC397 2026 + 0.128
CPD HCC397 2026 + 0.052
INS HCC397 2026 + 0.085

Mapped ICD-10-CM Diagnoses (76)

The following diagnoses map directly to HCC 397 under the V28 risk adjustment model:

ICD-10 Code Clinical Diagnosis Description Guideline
S06.1X3A Traumatic cerebral edema with loss of consciousness of 1 hour to 5 hours 59 minutes, initial encounter Notes ↗
S06.1X4A Traumatic cerebral edema with loss of consciousness of 6 hours to 24 hours, initial encounter Notes ↗
S06.1X5A Traumatic cerebral edema with loss of consciousness greater than 24 hours with return to pre-existing conscious level, initial encounter Notes ↗
S06.1X6A Traumatic cerebral edema with loss of consciousness greater than 24 hours without return to pre-existing conscious level with patient surviving, initial encounter Notes ↗
S06.2X3A Diffuse traumatic brain injury with loss of consciousness of 1 hour to 5 hours 59 minutes, initial encounter Notes ↗
S06.2X4A Diffuse traumatic brain injury with loss of consciousness of 6 hours to 24 hours, initial encounter Notes ↗
S06.2X5A Diffuse traumatic brain injury with loss of consciousness greater than 24 hours with return to pre-existing conscious levels, initial encounter Notes ↗
S06.2X6A Diffuse traumatic brain injury with loss of consciousness greater than 24 hours without return to pre-existing conscious level with patient surviving, initial encounter Notes ↗
S06.303A Unspecified focal traumatic brain injury with loss of consciousness of 1 hour to 5 hours 59 minutes, initial encounter Notes ↗
S06.304A Unspecified focal traumatic brain injury with loss of consciousness of 6 hours to 24 hours, initial encounter Notes ↗
S06.305A Unspecified focal traumatic brain injury with loss of consciousness greater than 24 hours with return to pre-existing conscious level, initial encounter Notes ↗
S06.306A Unspecified focal traumatic brain injury with loss of consciousness greater than 24 hours without return to pre-existing conscious level with patient surviving, initial encounter Notes ↗
S06.313A Contusion and laceration of right cerebrum with loss of consciousness of 1 hour to 5 hours 59 minutes, initial encounter Notes ↗
S06.314A Contusion and laceration of right cerebrum with loss of consciousness of 6 hours to 24 hours, initial encounter Notes ↗
S06.315A Contusion and laceration of right cerebrum with loss of consciousness greater than 24 hours with return to pre-existing conscious level, initial encounter Notes ↗
S06.316A Contusion and laceration of right cerebrum with loss of consciousness greater than 24 hours without return to pre-existing conscious level with patient surviving, initial encounter Notes ↗
S06.323A Contusion and laceration of left cerebrum with loss of consciousness of 1 hour to 5 hours 59 minutes, initial encounter Notes ↗
S06.324A Contusion and laceration of left cerebrum with loss of consciousness of 6 hours to 24 hours, initial encounter Notes ↗
S06.325A Contusion and laceration of left cerebrum with loss of consciousness greater than 24 hours with return to pre-existing conscious level, initial encounter Notes ↗
S06.326A Contusion and laceration of left cerebrum with loss of consciousness greater than 24 hours without return to pre-existing conscious level with patient surviving, initial encounter Notes ↗
S06.333A Contusion and laceration of cerebrum, unspecified, with loss of consciousness of 1 hour to 5 hours 59 minutes, initial encounter Notes ↗
S06.334A Contusion and laceration of cerebrum, unspecified, with loss of consciousness of 6 hours to 24 hours, initial encounter Notes ↗
S06.335A Contusion and laceration of cerebrum, unspecified, with loss of consciousness greater than 24 hours with return to pre-existing conscious level, initial encounter Notes ↗
S06.336A Contusion and laceration of cerebrum, unspecified, with loss of consciousness greater than 24 hours without return to pre-existing conscious level with patient surviving, initial encounter Notes ↗
S06.343A Traumatic hemorrhage of right cerebrum with loss of consciousness of 1 hours to 5 hours 59 minutes, initial encounter Notes ↗
S06.344A Traumatic hemorrhage of right cerebrum with loss of consciousness of 6 hours to 24 hours, initial encounter Notes ↗
S06.345A Traumatic hemorrhage of right cerebrum with loss of consciousness greater than 24 hours with return to pre-existing conscious level, initial encounter Notes ↗
S06.346A Traumatic hemorrhage of right cerebrum with loss of consciousness greater than 24 hours without return to pre-existing conscious level with patient surviving, initial encounter Notes ↗
S06.353A Traumatic hemorrhage of left cerebrum with loss of consciousness of 1 hours to 5 hours 59 minutes, initial encounter Notes ↗
S06.354A Traumatic hemorrhage of left cerebrum with loss of consciousness of 6 hours to 24 hours, initial encounter Notes ↗
S06.355A Traumatic hemorrhage of left cerebrum with loss of consciousness greater than 24 hours with return to pre-existing conscious level, initial encounter Notes ↗
S06.356A Traumatic hemorrhage of left cerebrum with loss of consciousness greater than 24 hours without return to pre-existing conscious level with patient surviving, initial encounter Notes ↗
S06.363A Traumatic hemorrhage of cerebrum, unspecified, with loss of consciousness of 1 hours to 5 hours 59 minutes, initial encounter Notes ↗
S06.364A Traumatic hemorrhage of cerebrum, unspecified, with loss of consciousness of 6 hours to 24 hours, initial encounter Notes ↗
S06.365A Traumatic hemorrhage of cerebrum, unspecified, with loss of consciousness greater than 24 hours with return to pre-existing conscious level, initial encounter Notes ↗
S06.366A Traumatic hemorrhage of cerebrum, unspecified, with loss of consciousness greater than 24 hours without return to pre-existing conscious level with patient surviving, initial encounter Notes ↗
S06.373A Contusion, laceration, and hemorrhage of cerebellum with loss of consciousness of 1 hour to 5 hours 59 minutes, initial encounter Notes ↗
S06.374A Contusion, laceration, and hemorrhage of cerebellum with loss of consciousness of 6 hours to 24 hours, initial encounter Notes ↗
S06.375A Contusion, laceration, and hemorrhage of cerebellum with loss of consciousness greater than 24 hours with return to pre-existing conscious level, initial encounter Notes ↗
S06.376A Contusion, laceration, and hemorrhage of cerebellum with loss of consciousness greater than 24 hours without return to pre-existing conscious level with patient surviving, initial encounter Notes ↗
S06.383A Contusion, laceration, and hemorrhage of brainstem with loss of consciousness of 1 hour to 5 hours 59 minutes, initial encounter Notes ↗
S06.384A Contusion, laceration, and hemorrhage of brainstem with loss of consciousness of 6 hours to 24 hours, initial encounter Notes ↗
S06.385A Contusion, laceration, and hemorrhage of brainstem with loss of consciousness greater than 24 hours with return to pre-existing conscious level, initial encounter Notes ↗
S06.386A Contusion, laceration, and hemorrhage of brainstem with loss of consciousness greater than 24 hours without return to pre-existing conscious level with patient surviving, initial encounter Notes ↗
S06.4X3A Epidural hemorrhage with loss of consciousness of 1 hour to 5 hours 59 minutes, initial encounter Notes ↗
S06.4X4A Epidural hemorrhage with loss of consciousness of 6 hours to 24 hours, initial encounter Notes ↗
S06.4X5A Epidural hemorrhage with loss of consciousness greater than 24 hours with return to pre-existing conscious level, initial encounter Notes ↗
S06.4X6A Epidural hemorrhage with loss of consciousness greater than 24 hours without return to pre-existing conscious level with patient surviving, initial encounter Notes ↗
S06.5X3A Traumatic subdural hemorrhage with loss of consciousness of 1 hour to 5 hours 59 minutes, initial encounter Notes ↗
S06.5X4A Traumatic subdural hemorrhage with loss of consciousness of 6 hours to 24 hours, initial encounter Notes ↗
S06.5X5A Traumatic subdural hemorrhage with loss of consciousness greater than 24 hours with return to pre-existing conscious level, initial encounter Notes ↗
S06.5X6A Traumatic subdural hemorrhage with loss of consciousness greater than 24 hours without return to pre-existing conscious level with patient surviving, initial encounter Notes ↗
S06.6X3A Traumatic subarachnoid hemorrhage with loss of consciousness of 1 hour to 5 hours 59 minutes, initial encounter Notes ↗
S06.6X4A Traumatic subarachnoid hemorrhage with loss of consciousness of 6 hours to 24 hours, initial encounter Notes ↗
S06.6X5A Traumatic subarachnoid hemorrhage with loss of consciousness greater than 24 hours with return to pre-existing conscious level, initial encounter Notes ↗
S06.6X6A Traumatic subarachnoid hemorrhage with loss of consciousness greater than 24 hours without return to pre-existing conscious level with patient surviving, initial encounter Notes ↗
S06.813A Injury of right internal carotid artery, intracranial portion, not elsewhere classified with loss of consciousness of 1 hour to 5 hours 59 minutes, initial encounter Notes ↗
S06.814A Injury of right internal carotid artery, intracranial portion, not elsewhere classified with loss of consciousness of 6 hours to 24 hours, initial encounter Notes ↗
S06.815A Injury of right internal carotid artery, intracranial portion, not elsewhere classified with loss of consciousness greater than 24 hours with return to pre-existing conscious level, initial encounter Notes ↗
S06.816A Injury of right internal carotid artery, intracranial portion, not elsewhere classified with loss of consciousness greater than 24 hours without return to pre-existing conscious level with patient surviving, initial encounter Notes ↗
S06.823A Injury of left internal carotid artery, intracranial portion, not elsewhere classified with loss of consciousness of 1 hour to 5 hours 59 minutes, initial encounter Notes ↗
S06.824A Injury of left internal carotid artery, intracranial portion, not elsewhere classified with loss of consciousness of 6 hours to 24 hours, initial encounter Notes ↗
S06.825A Injury of left internal carotid artery, intracranial portion, not elsewhere classified with loss of consciousness greater than 24 hours with return to pre-existing conscious level, initial encounter Notes ↗
S06.826A Injury of left internal carotid artery, intracranial portion, not elsewhere classified with loss of consciousness greater than 24 hours without return to pre-existing conscious level with patient surviving, initial encounter Notes ↗
S06.893A Other specified intracranial injury with loss of consciousness of 1 hour to 5 hours 59 minutes, initial encounter Notes ↗
S06.894A Other specified intracranial injury with loss of consciousness of 6 hours to 24 hours, initial encounter Notes ↗
S06.895A Other specified intracranial injury with loss of consciousness greater than 24 hours with return to pre-existing conscious level, initial encounter Notes ↗
S06.896A Other specified intracranial injury with loss of consciousness greater than 24 hours without return to pre-existing conscious level with patient surviving, initial encounter Notes ↗
S06.8A3A Primary blast injury of brain, not elsewhere classified with loss of consciousness of 1 hour to 5 hours 59 minutes, initial encounter Notes ↗
S06.8A4A Primary blast injury of brain, not elsewhere classified with loss of consciousness of 6 hours to 24 hours, initial encounter Notes ↗
S06.8A5A Primary blast injury of brain, not elsewhere classified with loss of consciousness greater than 24 hours with return to pre-existing conscious level, initial encounter Notes ↗
S06.8A6A Primary blast injury of brain, not elsewhere classified with loss of consciousness greater than 24 hours without return to pre-existing conscious level with patient surviving, initial encounter Notes ↗
S06.9X3A Unspecified intracranial injury with loss of consciousness of 1 hour to 5 hours 59 minutes, initial encounter Notes ↗
S06.9X4A Unspecified intracranial injury with loss of consciousness of 6 hours to 24 hours, initial encounter Notes ↗
S06.9X5A Unspecified intracranial injury with loss of consciousness greater than 24 hours with return to pre-existing conscious level, initial encounter Notes ↗
S06.9X6A Unspecified intracranial injury with loss of consciousness greater than 24 hours without return to pre-existing conscious level with patient surviving, initial encounter Notes ↗
← Back to V28 Categories Directory