A: Do not code coma in addition to the hemorrhage. When there is an anatomic brain injury the concussive codes are not used additionally. If the only injury is a skull fracture (no damage to the brain substance) and there is documented LOC you may use the concussive injury codes additionally.
I have a different opinion in regard to this question. When patient sustains serious or severe brain injury with hemorrhage to the brain, LOC is a consequence of this injury, not an injury itself. In this case I would not code LOC in addition. I may be wrong, but I use LOC code for concussive injuries only (mostly for mild TBI). The words “Concussion” and “mild TBI” has been used in literature interchangeably.