New GCS Guideline??

 ICD-10-CM Official Guidelines for Coding and Reporting FY 2020 (October 1, 2019 - September 30, 2020)

C. Chapter-Specific Coding Guidelines

18. Chapter 18: Symptoms, signs, and abnormal clinical and laboratory findings, not elsewhere classified (R00-R99)

e. Coma scale

The coma scale codes (R40.2-) can be used in conjunction with traumatic brain injury codes, acute cerebrovascular disease or sequelae of cerebrovascular disease codes. These codes are primarily for use by trauma registries, but they may be used in any setting where this information is collected. The coma scale may also be used to assess the status of the central nervous system for other non-trauma conditions, such as monitoring patients in the intensive care unit regardless of medical condition. The coma scale codes should be sequenced after the diagnosis code(s).

vs.

 ICD-10-CM Official Guidelines for Coding and Reporting FY 2021 (October 1, 2020 - September 30, 2021)

C. Chapter-Specific Coding Guidelines

18. Chapter 18: Symptoms, signs, and abnormal clinical and laboratory findings, not elsewhere classified (R00-R99)

e. Coma scale

The coma scale codes (R40.2-) can be used in conjunction with traumatic brain injury codes. These codes are primarily for use by trauma registries, but they may be used in any setting where this information is collected. The coma scale codes should be sequenced after the diagnosis code(s).

Does anyone interpret this as GCS are "no longer allowed for non traumatic brain injuries?"

What about anoxic brain damage due to other causes… i.e. overdose? 

Thank you.

Comments

  • I copied this statement from the guidelines you cited:



    The coma scale may also be used to assess the status of the central nervous system for other non-trauma conditions, such as monitoring patients in the intensive care unit regardless of medical condition

  • The 2021 guideline has several deleted sections. See: ICD-10-CM Official Guidelines for Coding and Reporting FY 2021 Page 78 of 126. e. Coma scale.


  • This was one of our topics today during our monthly CDI and Coding Quality meeting. Based upon the new 2021 guideline, we will only assign the coma scale codes in conjunction with TBI codes.

  • I was wondering the same thing. This will make a huge impact. Does the words "...but they may be used in any setting where this information is collected" mean it can still be coded with CVA's, etc....?

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