Q: A patient with clinical diagnosis of diffuse axonal injury (DAI) recorded by the neurosurgeon and a radiologic finding described as “petechial hemorrhages in the basal ganglia and corpus callosum consistent with DAI” who remains comatose until he dies 15 hours after injury should be assigned which AIS code?

A: The correct code is 140627.5. This question highlights the rule box on page 45 of the AIS dictionary, which directs the coder to “code only the more severe” when both corpus callosum and basal ganglia are noted. An important additional point to note is the directive If coma exceeds 24 hours, use 161011.5, no matter what anatomic description is recorded. The coder should note that DAI may also be coded on page 51 of the dictionary, under CONCUSSIVE INJURY. In all cases where coma exceeds 24 hours, DAI should be coded in this section of the dictionary rather than under Cerebrum. (This directive was clarified in the January 2008 edition of the AIS dictionary. See www.aaam1.org/ais for all dictionary updates and information on how to access the latest version of the dictionary.