Any injury to the head that interferes with the normal functioning of the brain can be referred to as a Traumatic Brain Injury (TBI). Several studies report an increase in the number of pediatric traumatic brain injuries. Trauma to the brain can be the result of a car crash, being shaken as a baby, falls, playground accident or child abuse. According to the CDC, around 435,000 Children aged between 0 and 14 visit the emergency department as a result of TBI every year. Recent research conducted at the Cincinnati Children’s Hospital found that children with severe TBI are five times more likely to develop secondary ADHD than children without TBI. The study found that the impact of a traumatic brain injury or TBI in a child can have long-lasting effects years later. As per the report, there are more than 630,000 children and teens in the United States treated in emergency rooms for TBI each year.

The study highlights that children with severe TBI show fewer symptoms if they grow up in optimal family environments, whereas children with mild injuries often display persistent symptoms if they come from a socially disadvantaged or chaotic family. The team also developed a web-based program that provides family-centered training in problem-solving, communication and self-regulation, which was shown to be effective in reducing behavior problems and executive dysfunction in older children with TBI.

Concussion in children is also common. Symptoms of acute concussion include vomiting, headache, crying and inability to be consoled, and restlessness or irritability.

The physician team treating the condition may include pediatricians, neurologists, neuro psychologist, occupational therapists (OT), physical therapists (PT) and speech-language pathologists. Pediatric medical billing for these neurological conditions must include specific ICD-10 codes.

ICD-10 provides the option to specify the brain and head injury conditions, such as:

• S00 – Superficial injury of head
• S01 – Open wound of head
• S03 – Dislocation and sprain of joints and ligaments of head
• S04 – Injury of cranial nerve
• S06 – Intracranial injury
• S06.0 – Concussion
• S07 – Crushing injury of head

Shaken baby syndrome refers to brain injuries resulting from vigorous shaking of an infant or young child held by the chest, shoulders, or extremities causing extreme rotational cranial acceleration. The condition can be coded with

• T74.4 – Shaken infant syndrome
• T74.4XXA – Shaken infant syndrome, initial encounter
• T74.4XXD – Shaken infant syndrome, subsequent encounter
• T74.4XXS – Shaken infant syndrome, sequela

Medical billing for these conditions involves extensive documentation and demands outstanding expertise in medical coding. To save valuable time and improve efficiency, physicians can choose to outsource their medical billing and coding tasks. HIPAA-compliant medical billing services offered by a reliable vendor can help busy neurologists and pediatricians obtain maximum reimbursement with cleaner claims and fewer re-filings and/or appeals.

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