A traumatic brain injury, or TBI, typically results from a violent jolt or blow to the body or head. For example, a bullet that penetrates brain tissue, can cause traumatic brain injury. While some milder forms of traumatic brain injury may affect your brain cells temporarily, more serious traumatic brain injury can result in torn brain tissue, bleeding, bruising or other physical damage to the brain.
There are several mechanisms that are most likely to cause a traumatic brain injury. These include an open head injury, a closed head injury, deceleration injuries, hypoxia, tumors, infections, stroke or exposure to chemicals or toxins. These causes may also indicate which specific ICD traumatic brain injury code should be used for diagnosis and reimbursement.
The course of treatment for traumatic brain injury depends on the severity of the injury. Mild traumatic brain injuries typically require no treatment other than resting and over-the-counter pain relievers for headaches. A moderate to severe traumatic brain injury requires immediate emergency care that is focused on ensuring the patient has enough oxygen and blood supply, maintaining blood pressure, and preventing any further injury to the head or neck.
Some medications that may be used to limit secondary damage to the brain include diuretics, anti-seizure drugs and coma-inducing drugs. Emergency surgery may also be required to minimize further damage to brain tissue. Surgery can be used to repair skull fractures, stop bleeding in the brain and removing clotted blood, or hematomas.
There are many different codes for ICD traumatic brain injury, depending on the type and severity of the injury.
The ICD-10 code S07.9 is for a crushing injury of head, part unspecified, and should not be used to indicate a diagnosis for reimbursement. There are multiple codes within ICD 10 code S07.9 that contain a greater level of detail. The 2018/2019 edition of ICD-10-CM S07.9 became effective on October 1, 2018.
The ICD-10 code S02.0 is for fracture of vault of skull and is a non-billable code. To code a diagnosis of this type for reimbursement purposes, you must specify a seventh character that describes the diagnosis, S02.0 fracture of vault of skull, in more detail.
The ICD 10 code S02 fracture of skull and facial bones, is a parent code and should not be used for reimbursement. There are multiple child codes that fall under S02 that contain a greater level of detail for a more specific diagnosis. For example, ICD-10 codes 3 S02.7-S02.9 include multiple fractures involving skull and facial bones, fractures of other skull and facial bones and fracture of skull and facial bones, part unspecified.
The specific ICD 10 code or codes used to indicate a more specific diagnosis of traumatic brain injury are newer codes that have replaced ICD 9 code traumatic brain injury. Any ICD 9 code for traumatic brain injury should be used for claims with a date of service on or before September 30, 2015. For claims with a date of service on or after October 1, 2015, use the traumatic brain injury ICD 10 code or codes, as opposed to traumatic brain injury ICD 9 code or codes.