S06.4X7A
Epidural hemorrhage with loss of consciousness of any duration with death due to brain injury prior to regaining consciousness, initial encounter
S06.4X7A (also written S064X7A) is a billable ICD-10-CM diagnosis code for epidural hemorrhage with loss of consciousness of any duration with death due to brain injury prior to regaining consciousness, initial encounter. It is part of the FY2027 code set, effective October 1, 2026. It is one of the 569 codes in category S06 (Intracranial injury). Its 7th character, A, means initial encounter. Its coding notes include a Use additional code instruction, a Code also instruction, 1 Excludes1 entry and 11 Excludes2 entries.
7th character
Category S06 requires a 7th character.
Guidelines tips
From the FY2027 Official Guidelines. ICD10Ref adds no rules of its own.
The 7th character depends on whether the patient is in active treatment, not on who sees the patient. An aftercare Z code is not used for injury aftercare.
Each injury gets its own code unless a combination code exists, with the most serious injury first. Superficial injuries at the same site as a more severe injury are not coded. Injuries during medical care are coded as complications.
Use additional code
Add the listed code as a secondary code, if known.
- code, if applicable, to identify mild neurocognitive disorders due to known physiological condition (F06.7-)
Also from chapter/block level (1 note)
- code to identify any retained foreign body, if applicable (Z18.-)
Code also
Two codes may be needed to describe the condition. This note gives no sequencing order.
Also from chapter/block level (1 note)
- for any associated infection
Excludes1
Not coded here. The listed conditions generally should not be reported together.
Excludes2
Not included here. Both codes may be reported if the patient has both conditions.
Also from chapter/block level (11 notes)
- burns and corrosions (T20-T32)
- effects of foreign body in ear (T16)
- effects of foreign body in larynx (T17.3)
- effects of foreign body in mouth NOS (T18.0)
- effects of foreign body in nose (T17.0-T17.1)
- effects of foreign body in pharynx (T17.2)
- effects of foreign body on external eye (T15.-)
- frostbite (T33-T34)
- insect bite or sting, venomous (T63.4)
- birth trauma (P10-P15)
- obstetric trauma (O70-O71)
Care settings
How CMS programs treat this code. These are CMS claim edits and list entries, not coverage or eligibility rules.
IRF 60% Rule
On the CMS list of diagnoses used to determine presumptive compliance with the IRF 60 percent rule.
Source: CMS IRF Presumptive Compliance-3, FY 2027 IRF PPS final rule files, effective for discharges on or after October 1, 2026Hospital MCC
Counts as a major complication or comorbidity (MCC) when reported as a secondary diagnosis on an inpatient claim. It does not count when the principal diagnosis is one of the 383 codes in its exclusion list. Some MS-DRGs also ignore a CC or MCC that defines the DRG.
Source: CMS MS-DRG Definitions Manual v44, effective October 1, 2026, Appendix CHAC
On the CMS list of hospital-acquired conditions (HAC 05: Falls and Trauma). When the claim reports it with a present-on-admission (POA) indicator of N (not present) or U (documentation insufficient), CMS does not pay the CC or MCC DRG for it. A POA of Y (present) or W (clinically undetermined) is paid normally.
Source: CMS MS-DRG Definitions Manual v44, effective October 1, 2026, Appendix I; CMS Hospital-Acquired Conditions (HAC) Coding page, POA indicator payment tableIncludes
Further defines or gives examples of the content of the category.
- traumatic brain injury
Also from chapter/block level (12 notes)
- 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
Notes
- 7th characters D and S do not apply to codes in category S06 with 6th character 7 - death due to brain injury prior to regaining consciousness, or 8 - death due to other cause prior to regaining consciousness.
Also from chapter/block level (2 notes)
- Use secondary code(s) from Chapter 20, External causes of morbidity, to indicate cause of injury. Codes within the T section that include the external cause do not require an additional external cause code
- The chapter uses the S-section for coding different types of injuries related to single body regions and the T-section to cover injuries to unspecified body regions as well as poisoning and certain other consequences of external causes.