Concussion

• Sport-related concussion
• Mild traumatic brain injury (mTBI)
• Post-concussion syndrome
• Second impact syndrome

• 850 Concussion
• 850.0 With no loss of consciousness
• 850.11 With brief loss of consciousness (less than 30 minutes)
• 850.12 With brief loss of consciousness (31 to 59 minutes)
• 850.2 With moderate loss of consciousness (1 to 24 hours)
• 850.3 With prolonged loss of consciousness and return to pre-existing consciousness level (24 hours + with full recovery)
• 850.4 With prolonged loss of consciousness, without return to pre-existing consciousness level
• 850.5 Loss of consciousness of unspecified duration
• 850.9 Concussion unspecified

• S06.0 Concussion
• S06.0X0A Without loss of consciousness, initial encounter
• S06.0X0D Without loss of consciousness, subsequent encounter
• S06.0X0S Without loss of consciousness, sequela
• S06.0X1 Concussion with loss of consciousness of 30 minutes or less
• S06.0X2 Concussion with loss of consciousness of 31 minutes to 59 minutes
• S06.0X3 Concussion with loss of consciousness of 1 hour to 5 hours 59 minutes
• S06.0X4 Concussion with loss of consciousness of 6 hours to 24 hours, initial encounter
• S06.0X5 Concussion with loss of consciousness greater than 24 hours with return to pre existing conscious level
• S06.0X6 Concussion with loss of consciousness greater than 24 hours without return to pre-existing conscious level with patient surviving
• S06.0X7 Concussion with loss of consciousness of any duration with death due to brain injury prior to regaining consciousness
• S06.0X8 Concussion with loss of consciousness of any duration with death due to other cause prior to regaining consciousness
• S06.0X9 Concussion with loss of consciousness of unspecified duration

• 5C: Impaired Motor Function and Sensory Integrity Associated With Nonprogressive Disorders of the Central Nervous System - Congenital Origin or Acquired in Infancy or Childhood
• 5D: Impaired Motor Function and Sensory Integrity Associated With Nonprogressive Disorders of the Central Nervous System - Acquired in Adolescence or Adulthood
• 5I: Impaired Arousal, Range of Motion, and Motor Control Associated With Coma, Near Coma, or Vegetative State

Description

• Complex pathophysiological process affecting the brain; induced by traumatic biomechanical force2
• May be caused by direct blow to the head, face, neck, elsewhere on the body with impulsive force transmitted to the head
• May occur from linear deceleration injury or rotational injury3
  • Seventeen times more likely to occur with linear acceleration > 100g
  • Fourteen times more likely to occur with rotational acceleration > 5000 rad/sec
• “Simple” vs. “Complex” concussions4,5
  • Simple: symptoms resolve in 7-10 days, no intervention beyond limiting play, rest until symptoms resolve
  • Complex: symptoms persist > 10 days or loss of consciousness > 1 minute; neuropsychological testing and multidisciplinary approach recommended for individuals with history of head injuries
  • Complex concussions 18x more likely than simple concussions to have impaired composite scores on neurocognitive testing for 3 out of 4 on visual memory, reaction time, processing speed, or symptom scores
• Second impact syndrome: life-threatening condition, may be triggered by very minor impact while individual still suffering symptoms of initial concussion6

Essentials of ...