CAISS – Head Top Grade Questions and Correct Answers

What does AIS define as part of the Head - Scalp, Skull, Brain, Intracranial Vessels, Cranial Nerves. What makes up the Meninges? - Dura Mater(epidural/subdural), Arachnoid(csf), pia matter(vascular membrane) What are the regions of the brain? - Brain Stem, Cerebellum, Cerebrum What is a Focal Brain Injury? - Space occupying lesion in which the brain will shift or herniate What is a Diffuse Brain Injury? - Global/Widespread damaging affecting consciousness In the skull; what does "Compound" mean? - Open Fracture Coding of brain injuries should be done when? - At 24 hours or at initial confirmed diagnosis if later than 24 hours. When can LOC be coded? - When there is convincing evidence of head trauma and the diagnosis is made by a physician. Provider diagnosis the patient with a "Closed Head Injury" how do you code this? - 100099.9; NFS Patient is diagnosed with a Compound Temporal Fracture and laceration of the Temporal Artery. Can you code both injuries? - Yes When is a cranial nerve coded as a laceration? - When there is Total Loss of Nerve Function Paralysis When is a Cranial Nerve coded as a Contusion? - When there is subtotal/partial loss of function. Paresis / Palsy What affects the Injury Severity Score of brain lesions? - Size, Location, Multiplicity What does "Closed Cisterns" imply? - Brain Swelling At what age are brain severity injuries adjusted? - 10 & younger If a single fracture involves both base and vault; how do you code? - Code the most severe. If equal code to the point of origin. How should all skull fractures be coded? - Code to Vault unless specified as base. What bones are included in a Skull Base Fracture? - Ethmoid, Sphenoid, Orbital Roof, Petrous, Mastoid of Temporal Given evidence of head injury; what can be used to corroborate a diagnosis of basilar skull fracture? - Battle Signs, CSF (Otorrhea/Rhinorrhea) or Raccoon Eyes Diagnosis of shearing of white matter with immediate prolonged coma; - Diffuse Axonal Injury (DAI) What brain findings cannot be coded with a Diffuse Axonal Injury(DAI) diagnosis? - IVH, ischemic brain damage, SAH and Subpial hemorrhage How is coma coded with multiple brain findings? - Code only once to the finding that will result in the highest ISS.