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398 HCC

Major Head Injury with Loss of Consciousness < 1 Hour or Unspecified

CMS Model V28 57 Associated ICD-10 Diagnoses

Relative Risk Score Factors (Coefficients for HCC 398)

Enrollment Model Type Coeff Tag Year Weight Score
CFA HCC398 2026 + 0.349
CFD HCC398 2026 + 0.190
CNA HCC398 2026 + 0.199
CND HCC398 2026 + 0.150
CPA HCC398 2026 + 0.128
CPD HCC398 2026 + 0.052
INS HCC398 2026 + 0.085

Mapped ICD-10-CM Diagnoses (57)

The following diagnoses map directly to HCC 398 under the V28 risk adjustment model:

ICD-10 Code Clinical Diagnosis Description Guideline
S06.1X1A Traumatic cerebral edema with loss of consciousness of 30 minutes or less, initial encounter Notes ↗
S06.1X2A Traumatic cerebral edema with loss of consciousness of 31 minutes to 59 minutes, initial encounter Notes ↗
S06.1X9A Traumatic cerebral edema with loss of consciousness of unspecified duration, initial encounter Notes ↗
S06.2X1A Diffuse traumatic brain injury with loss of consciousness of 30 minutes or less, initial encounter Notes ↗
S06.2X2A Diffuse traumatic brain injury with loss of consciousness of 31 minutes to 59 minutes, initial encounter Notes ↗
S06.2X9A Diffuse traumatic brain injury with loss of consciousness of unspecified duration, initial encounter Notes ↗
S06.301A Unspecified focal traumatic brain injury with loss of consciousness of 30 minutes or less, initial encounter Notes ↗
S06.302A Unspecified focal traumatic brain injury with loss of consciousness of 31 minutes to 59 minutes, initial encounter Notes ↗
S06.309A Unspecified focal traumatic brain injury with loss of consciousness of unspecified duration, initial encounter Notes ↗
S06.311A Contusion and laceration of right cerebrum with loss of consciousness of 30 minutes or less, initial encounter Notes ↗
S06.312A Contusion and laceration of right cerebrum with loss of consciousness of 31 minutes to 59 minutes, initial encounter Notes ↗
S06.319A Contusion and laceration of right cerebrum with loss of consciousness of unspecified duration, initial encounter Notes ↗
S06.321A Contusion and laceration of left cerebrum with loss of consciousness of 30 minutes or less, initial encounter Notes ↗
S06.322A Contusion and laceration of left cerebrum with loss of consciousness of 31 minutes to 59 minutes, initial encounter Notes ↗
S06.329A Contusion and laceration of left cerebrum with loss of consciousness of unspecified duration, initial encounter Notes ↗
S06.331A Contusion and laceration of cerebrum, unspecified, with loss of consciousness of 30 minutes or less, initial encounter Notes ↗
S06.332A Contusion and laceration of cerebrum, unspecified, with loss of consciousness of 31 minutes to 59 minutes, initial encounter Notes ↗
S06.339A Contusion and laceration of cerebrum, unspecified, with loss of consciousness of unspecified duration, initial encounter Notes ↗
S06.341A Traumatic hemorrhage of right cerebrum with loss of consciousness of 30 minutes or less, initial encounter Notes ↗
S06.342A Traumatic hemorrhage of right cerebrum with loss of consciousness of 31 minutes to 59 minutes, initial encounter Notes ↗
S06.349A Traumatic hemorrhage of right cerebrum with loss of consciousness of unspecified duration, initial encounter Notes ↗
S06.351A Traumatic hemorrhage of left cerebrum with loss of consciousness of 30 minutes or less, initial encounter Notes ↗
S06.352A Traumatic hemorrhage of left cerebrum with loss of consciousness of 31 minutes to 59 minutes, initial encounter Notes ↗
S06.359A Traumatic hemorrhage of left cerebrum with loss of consciousness of unspecified duration, initial encounter Notes ↗
S06.361A Traumatic hemorrhage of cerebrum, unspecified, with loss of consciousness of 30 minutes or less, initial encounter Notes ↗
S06.362A Traumatic hemorrhage of cerebrum, unspecified, with loss of consciousness of 31 minutes to 59 minutes, initial encounter Notes ↗
S06.369A Traumatic hemorrhage of cerebrum, unspecified, with loss of consciousness of unspecified duration, initial encounter Notes ↗
S06.371A Contusion, laceration, and hemorrhage of cerebellum with loss of consciousness of 30 minutes or less, initial encounter Notes ↗
S06.372A Contusion, laceration, and hemorrhage of cerebellum with loss of consciousness of 31 minutes to 59 minutes, initial encounter Notes ↗
S06.379A Contusion, laceration, and hemorrhage of cerebellum with loss of consciousness of unspecified duration, initial encounter Notes ↗
S06.381A Contusion, laceration, and hemorrhage of brainstem with loss of consciousness of 30 minutes or less, initial encounter Notes ↗
S06.382A Contusion, laceration, and hemorrhage of brainstem with loss of consciousness of 31 minutes to 59 minutes, initial encounter Notes ↗
S06.389A Contusion, laceration, and hemorrhage of brainstem with loss of consciousness of unspecified duration, initial encounter Notes ↗
S06.4X1A Epidural hemorrhage with loss of consciousness of 30 minutes or less, initial encounter Notes ↗
S06.4X2A Epidural hemorrhage with loss of consciousness of 31 minutes to 59 minutes, initial encounter Notes ↗
S06.4X9A Epidural hemorrhage with loss of consciousness of unspecified duration, initial encounter Notes ↗
S06.5X1A Traumatic subdural hemorrhage with loss of consciousness of 30 minutes or less, initial encounter Notes ↗
S06.5X2A Traumatic subdural hemorrhage with loss of consciousness of 31 minutes to 59 minutes, initial encounter Notes ↗
S06.5X9A Traumatic subdural hemorrhage with loss of consciousness of unspecified duration, initial encounter Notes ↗
S06.6X1A Traumatic subarachnoid hemorrhage with loss of consciousness of 30 minutes or less, initial encounter Notes ↗
S06.6X2A Traumatic subarachnoid hemorrhage with loss of consciousness of 31 minutes to 59 minutes, initial encounter Notes ↗
S06.6X9A Traumatic subarachnoid hemorrhage with loss of consciousness of unspecified duration, initial encounter Notes ↗
S06.811A Injury of right internal carotid artery, intracranial portion, not elsewhere classified with loss of consciousness of 30 minutes or less, initial encounter Notes ↗
S06.812A Injury of right internal carotid artery, intracranial portion, not elsewhere classified with loss of consciousness of 31 minutes to 59 minutes, initial encounter Notes ↗
S06.819A Injury of right internal carotid artery, intracranial portion, not elsewhere classified with loss of consciousness of unspecified duration, initial encounter Notes ↗
S06.821A Injury of left internal carotid artery, intracranial portion, not elsewhere classified with loss of consciousness of 30 minutes or less, initial encounter Notes ↗
S06.822A Injury of left internal carotid artery, intracranial portion, not elsewhere classified with loss of consciousness of 31 minutes to 59 minutes, initial encounter Notes ↗
S06.829A Injury of left internal carotid artery, intracranial portion, not elsewhere classified with loss of consciousness of unspecified duration, initial encounter Notes ↗
S06.891A Other specified intracranial injury with loss of consciousness of 30 minutes or less, initial encounter Notes ↗
S06.892A Other specified intracranial injury with loss of consciousness of 31 minutes to 59 minutes, initial encounter Notes ↗
S06.899A Other specified intracranial injury with loss of consciousness of unspecified duration, initial encounter Notes ↗
S06.8A1A Primary blast injury of brain, not elsewhere classified with loss of consciousness of 30 minutes or less, initial encounter Notes ↗
S06.8A2A Primary blast injury of brain, not elsewhere classified with loss of consciousness of 31 minutes to 59 minutes, initial encounter Notes ↗
S06.8A9A Primary blast injury of brain, not elsewhere classified with loss of consciousness of unspecified duration, initial encounter Notes ↗
S06.9X1A Unspecified intracranial injury with loss of consciousness of 30 minutes or less, initial encounter Notes ↗
S06.9X2A Unspecified intracranial injury with loss of consciousness of 31 minutes to 59 minutes, initial encounter Notes ↗
S06.9X9A Unspecified intracranial injury with loss of consciousness of unspecified duration, initial encounter Notes ↗
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