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S06.A1XA ICD-10-CM Code: Traumatic brain compression with herniation, initial encounter

Billing Status: YES. This is a valid, specific, and billable ICD-10-CM reference.

Inpatient Payment Groups (MS-DRG)

MS-DRGs this diagnosis helps define, as principal or secondary, per the CMS ICD-10-CM/PCS MS-DRG Definitions Manual v43.0, Appendix B.

  • MS-DRG 011 — TRACHEOSTOMY FOR FACE, MOUTH AND NECK DIAGNOSES OR LARYNGECTOMY WITH MCC (MDC PRE)
  • MS-DRG 012 — TRACHEOSTOMY FOR FACE, MOUTH AND NECK DIAGNOSES OR LARYNGECTOMY WITH CC (MDC PRE)
  • MS-DRG 013 — TRACHEOSTOMY FOR FACE, MOUTH AND NECK DIAGNOSES OR LARYNGECTOMY WITHOUT CC/MCC (MDC PRE)
  • MS-DRG 085 — TRAUMATIC STUPOR AND COMA <1 HOUR WITH MCC (MDC 01)
  • MS-DRG 086 — TRAUMATIC STUPOR AND COMA <1 HOUR WITH CC (MDC 01)
  • MS-DRG 087 — TRAUMATIC STUPOR AND COMA <1 HOUR WITHOUT CC/MCC (MDC 01)
  • MS-DRG 963 — OTHER MULTIPLE SIGNIFICANT TRAUMA WITH MCC (MDC 24)
  • MS-DRG 964 — OTHER MULTIPLE SIGNIFICANT TRAUMA WITH CC (MDC 24)
  • MS-DRG 965 — OTHER MULTIPLE SIGNIFICANT TRAUMA WITHOUT CC/MCC (MDC 24)

A diagnosis appearing in a group's logic does not by itself determine the DRG assigned to a stay; the grouper uses the full claim.

Risk Adjustment (CMS-HCC)

Payment categories this diagnosis maps to under CMS-HCC V28, payment year 2026.

  • HCC 399 — Major Head Injury without Loss of Consciousness

Other models: CMS-HCC V22 HCC 167

Risk scores depend on the enrollee's full accepted diagnosis set and segment; a category mapping alone does not determine payment.

Official Registry Overview & Definition

Traumatic brain compression with herniation, initial encounter is a billable ICD-10-CM diagnosis code (S06.A1A).

Official Tabular Instructional Notes

Sequencing, inclusion, and exclusion notes published for S06.A1XA in the official ICD-10-CM tabular list.

Includes

Conditions the official ICD-10-CM tabular list includes under this code.

  • traumatic brain injury
  • injuries of ear
  • injuries of eye
  • injuries of face [any part]
  • injuries of gum
  • injuries of jaw
  • injuries of oral cavity
  • injuries of palate
  • injuries of periocular area
  • injuries of scalp
  • injuries of temporomandibular joint area
  • injuries of tongue
  • injuries of tooth

Inclusion Terms

Alternative terms the tabular list files under this code.

  • Traumatic brain herniation
  • Traumatic brainstem compression with herniation
  • Traumatic cerebellar compression with herniation
  • Traumatic cerebral compression with herniation

Excludes1 — Not Coded Here

Conditions generally not reported together with this code (Excludes1) -- an error unless the two conditions are documented as unrelated to each other (ICD-10-CM Official Guidelines, Section I.A.12.a).

Excludes2 — Not Included Here

Conditions not covered by this code, but which may be reported alongside it when both are present.

Code First

Underlying conditions that must be sequenced before this code.

  • the underlying traumatic brain injury, such as:
  • diffuse traumatic brain injury (S06.2-)
  • focal traumatic brain injury (S06.3-)
  • traumatic subdural hemorrhage (S06.5-)
  • traumatic subarachnoid hemorrhage (S06.6-)

Code Also

Additional codes that may be required to fully describe the encounter.

  • any associated:
  • open wound of head (S01.-)
  • skull fracture (S02.-)
  • for any associated infection

Use Additional Code

Supplementary codes the tabular list directs you to add.

  • Use additional code, if applicable, to identify mild neurocognitive disorders due to known physiological condition (F06.7-)

Frequently Compared Codes

The official Excludes notes on S06.A1XA name these codes. Each comparison page covers when the two can — or must not — be reported together.

Change history

  • FY2022 — 2021-10-01
    Added to the code set
    Traumatic brain compression with herniation, initial encounter
    FY2022 changes

Verify Before Coding

  • Principal-diagnosis restriction. The Medicare Code Editor lists this code as unacceptable as a principal diagnosis: it describes a circumstance influencing health status rather than a current illness or injury being treated. It is valid as a secondary diagnosis.
  • MCC as a secondary diagnosis (FY2026). Can raise the stay's MS-DRG severity tier.

From the code registry, the Medicare Code Editor, and the MS-DRG Definitions Manual. Check it against a full claim.

Relationships & Classification

Official ICD-10-CM tabular notes on other codes that name S06.A1XA or its code family.

14 Excludes1 notes across 4 chapters: G31.84 (via S06.-), G93.5 (via S06.A.-), I60 (via S06.-), I60-I69 (via S06.-), I61 (via S06.-), I62 (via S06.-), I63 (via S06.-), I65 (via S06.-), I66 (via S06.-), I67 (via S06.-) and 4 more.

5 Code First instructions across 3 chapters: F02 (via S06.-), F06.7 (via S06.-), F48.2 (via S06.-), R40.2 (via S06.-), S04 (via S06.-).

5 Use Additional Code instructions: S06.2 (via S06.A.-), S06.3 (via S06.A.-), S06.5 (via S06.A.-), S06.6 (via S06.A.-), S07 (via S06.-).

2 Code Also instructions: S01 (via S06.-), S02 (via S06.-).

Potential MS-DRG Relationships (FY2026)

MCC — Major Complication or Comorbidity. Reported as a secondary diagnosis, this code raises the stay's MS-DRG severity tier — except when the principal diagnosis is one of 3 clinically related codes on its CMS exclusion list. Does not count toward severity when the stay groups to DRGs 957-959 (Other O.R. Procedures for Multiple Significant Trauma); DRGs 963-965 (Other Multiple Significant Trauma).

Named in the grouper logic of 9 MS-DRGs: DRG 011 (MDC PRE), DRG 012 (MDC PRE), DRG 013 (MDC PRE), DRG 085 (MDC 01), DRG 086 (MDC 01), DRG 087 (MDC 01), DRG 963 (MDC 24), DRG 964 (MDC 24), DRG 965 (MDC 24).

From the CMS MS-DRG Definitions Manual (Appendices B and C). Actual DRG assignment depends on the complete claim.

Clinical classification (AHRQ CCSR):INJ008 — Traumatic brain injury (TBI); concussion, initial encounter (default).

Clinical Classifications Software Refined (CCSR) for ICD-10-CM Diagnoses. Healthcare Cost and Utilization Project (HCUP), Agency for Healthcare Research and Quality.

Contextual Map

Every relationship of S06.A1XA in one view: hierarchy, official tabular instructions in both directions, clinical classification, risk adjustment, MS-DRG participation, index terms and change history — each edge carrying the CMS source it derives from.

Hierarchy

  • S00-T88 — Chapter 19: Injury, Poisoning and Certain Other Consequences of External Causes (S00-T88) (S00-T88) [Hierarchy]
  • S00-S09 — Injuries to the head [Hierarchy]

Referenced by Excludes1 notes (14)

  • G31.84 — Mild cognitive impairment of uncertain or unknown etiology [Excludes1](via S06.-): “cognitive impairment due to intracranial or head injury (S06.-)” · check together
  • G93.5 — Compression of brain [Excludes1](via S06.A.-): “traumatic compression of brain (S06.A-)” · check together
  • I60 — Nontraumatic subarachnoid hemorrhage [Excludes1](via S06.-): “traumatic intracranial hemorrhage (S06.-)” · check together
  • I60-I69 — Cerebrovascular diseases (I60-I69) [Excludes1](via S06.-): “traumatic intracranial hemorrhage (S06.-)” · check together
  • I61 — Nontraumatic intracerebral hemorrhage [Excludes1](via S06.-): “traumatic intracranial hemorrhage (S06.-)” · check together
  • I62 — Other and unspecified nontraumatic intracranial hemorrhage [Excludes1](via S06.-): “traumatic intracranial hemorrhage (S06.-)” · check together
  • I63 — Cerebral infarction [Excludes1](via S06.-): “traumatic intracranial hemorrhage (S06.-)” · check together
  • I65 — Occlusion and stenosis of precerebral arteries, not resulting in cerebral infarction [Excludes1](via S06.-): “traumatic intracranial hemorrhage (S06.-)” · check together
  • and 6 more

Referenced by Code First instructions

  • F02 — Dementia in other diseases classified elsewhere [Code First](via S06.-): “traumatic brain injury (S06.-)” · check together
  • F06.7 — Mild neurocognitive disorder due to known physiological condition [Code First](via S06.-): “traumatic brain injury (S06.-)” · check together
  • F48.2 — Pseudobulbar affect [Code First](via S06.-): “sequelae of traumatic intracranial injury (S06.-)” · check together
  • R40.2 — Coma [Code First](via S06.-): “intracranial injury (S06.-)” · check together
  • S04 — Injury of cranial nerve [Code First](via S06.-): “any associated intracranial injury (S06.-)” · check together

Referenced by Use Additional Code instructions

  • S06.2 — Diffuse traumatic brain injury [Use Additional Code](via S06.A.-): “code, if applicable, for traumatic brain compression or herniation (S06.A-)” · check together
  • S06.3 — Focal traumatic brain injury [Use Additional Code](via S06.A.-): “code, if applicable, for traumatic brain compression or herniation (S06.A-)” · check together
  • S06.5 — Traumatic subdural hemorrhage [Use Additional Code](via S06.A.-): “code, if applicable, for traumatic brain compression or herniation (S06.A-)” · check together
  • S06.6 — Traumatic subarachnoid hemorrhage [Use Additional Code](via S06.A.-): “code, if applicable, for traumatic brain compression or herniation (S06.A-)” · check together
  • S07 — Crushing injury of head [Use Additional Code](via S06.-): “intracranial injuries (S06.-)” · check together

Referenced by Code Also instructions

  • S01 — Open wound of head [Code Also](via S06.-): “intracranial injury (S06.-)” · check together
  • S02 — Fracture of skull and facial bones [Code Also](via S06.-): “any associated intracranial injury (S06.-)” · check together

Clinical classification (CCSR)

  • INJ008 — Traumatic brain injury (TBI); concussion, initial encounter [CCSR]

Risk adjustment (CMS-HCC)

  • HCC 399 — Major Head Injury without Loss of Consciousness [CMS-HCC]

Potential MS-DRG (9)

  • MCC — Major Complication or Comorbidity [MS-DRG severity]: “As a secondary diagnosis this code can raise the stay's MS-DRG severity tier (MCC). Not counted when the stay groups to DRGs 957-959 (Other O.R. Procedures for Multiple Significant Trauma); DRGs 963-965 (Other Multiple Significant Trauma).”
  • DRG 011 — TRACHEOSTOMY FOR FACE, MOUTH AND NECK DIAGNOSES OR LARYNGECTOMY WITH MCC [MS-DRG]: “TRACHEOSTOMY FOR FACE, MOUTH AND NECK DIAGNOSES OR LARYNGECTOMY WITH MCC (MDC PRE)”
  • DRG 012 — TRACHEOSTOMY FOR FACE, MOUTH AND NECK DIAGNOSES OR LARYNGECTOMY WITH CC [MS-DRG]: “TRACHEOSTOMY FOR FACE, MOUTH AND NECK DIAGNOSES OR LARYNGECTOMY WITH CC (MDC PRE)”
  • DRG 013 — TRACHEOSTOMY FOR FACE, MOUTH AND NECK DIAGNOSES OR LARYNGECTOMY WITHOUT CC/MCC [MS-DRG]: “TRACHEOSTOMY FOR FACE, MOUTH AND NECK DIAGNOSES OR LARYNGECTOMY WITHOUT CC/MCC (MDC PRE)”
  • DRG 085 — TRAUMATIC STUPOR AND COMA <1 HOUR WITH MCC [MS-DRG]: “TRAUMATIC STUPOR AND COMA <1 HOUR WITH MCC (MDC 01)”
  • DRG 086 — TRAUMATIC STUPOR AND COMA <1 HOUR WITH CC [MS-DRG]: “TRAUMATIC STUPOR AND COMA <1 HOUR WITH CC (MDC 01)”
  • DRG 087 — TRAUMATIC STUPOR AND COMA <1 HOUR WITHOUT CC/MCC [MS-DRG]: “TRAUMATIC STUPOR AND COMA <1 HOUR WITHOUT CC/MCC (MDC 01)”
  • DRG 963 — OTHER MULTIPLE SIGNIFICANT TRAUMA WITH MCC [MS-DRG]: “OTHER MULTIPLE SIGNIFICANT TRAUMA WITH MCC (MDC 24)”
  • and 2 more

MDC crossing · procedures (32002)

  • Pre-MDC[MDC crossing]: “Pre-MDC — the grouper's crossing between diagnoses and procedures: a principal diagnosis sets the MDC, and same-MDC procedures move the stay to its surgical DRGs.”
  • MDC 01 — Diseases and Disorders of the Nervous System [MDC crossing]: “Diseases and Disorders of the Nervous System — the grouper's crossing between diagnoses and procedures: a principal diagnosis sets the MDC, and same-MDC procedures move the stay to its surgical DRGs.”
  • 02HA0QZ — Insertion of Implantable Heart Assist System into Heart, Open Approach [Same-MDC procedure]: “Insertion of Implantable Heart Assist System into Heart, Open Approach — grouped in MDC PRE, the procedure side of this code's crossing.” · check together
  • 02HA0RZ — Insertion of Short-term External Heart Assist System into Heart, Open Approach [Same-MDC procedure]: “Insertion of Short-term External Heart Assist System into Heart, Open Approach — grouped in MDC PRE, the procedure side of this code's crossing.” · check together
  • 02HA3QZ — Insertion of Implantable Heart Assist System into Heart, Percutaneous Approach [Same-MDC procedure]: “Insertion of Implantable Heart Assist System into Heart, Percutaneous Approach — grouped in MDC PRE, the procedure side of this code's crossing.” · check together
  • 02HA4QZ — Insertion of Implantable Heart Assist System into Heart, Percutaneous Endoscopic Approach [Same-MDC procedure]: “Insertion of Implantable Heart Assist System into Heart, Percutaneous Endoscopic Approach — grouped in MDC PRE, the procedure side of this code's crossing.” · check together
  • 02RA0LZ — Replacement of Heart with Biologic and Synthetic Substitute, Autoregulated Electrohydraulic, Open Approach [Same-MDC procedure]: “Replacement of Heart with Biologic and Synthetic Substitute, Autoregulated Electrohydraulic, Open Approach — grouped in MDC PRE, the procedure side of this code's crossing.” · check together
  • and 31997 more

Nearest codes (40)

  • S06 — Intracranial injury [Sibling]
  • S06.9X2 — Unspecified intracranial injury with loss of consciousness of 31 minutes to 59 minutes [Sibling]
  • S06.9X2A — Unspecified intracranial injury with loss of consciousness of 31 minutes to 59 minutes, initial encounter [Sibling]
  • S06.9X2D — Unspecified intracranial injury with loss of consciousness of 31 minutes to 59 minutes, subsequent encounter [Sibling]
  • S06.9X2S — Unspecified intracranial injury with loss of consciousness of 31 minutes to 59 minutes, sequela [Sibling]
  • S06.9X3 — Unspecified intracranial injury with loss of consciousness of 1 hour to 5 hours 59 minutes [Sibling]
  • S06.9X3A — Unspecified intracranial injury with loss of consciousness of 1 hour to 5 hours 59 minutes, initial encounter [Sibling]
  • S06.9X3D — Unspecified intracranial injury with loss of consciousness of 1 hour to 5 hours 59 minutes, subsequent encounter [Sibling]
  • and 32 more

Change history

  • FY2022 — Added to the code set [Change history]

Frequently Asked Questions (FAQ) & Clinical Guidance

Does S06.A1XA require a 7th character?

Yes. The appropriate 7th character is to be added to each code from category S06, except as noted below.

Nearest Codes in This Family

Official ICD-10-CM classifications closest to S06.A1XA in its code family, with their registry titles.

  • S06.9XAA — Unspecified intracranial injury with loss of consciousness status unknown, initial encounter
  • S06.9XAD — Unspecified intracranial injury with loss of consciousness status unknown, subsequent encounter
  • S06.9XAS — Unspecified intracranial injury with loss of consciousness status unknown, sequela
  • S06.A — Traumatic brain compression and herniation
  • S06.A0 — Traumatic brain compression without herniation
  • S06.A0XA — Traumatic brain compression without herniation, initial encounter
  • S06.A0XD — Traumatic brain compression without herniation, subsequent encounter
  • S06.A0XS — Traumatic brain compression without herniation, sequela
  • S06.A1 — Traumatic brain compression with herniation
  • S06.A1XD — Traumatic brain compression with herniation, subsequent encounter

View all codes in the S06 family