A: All injuries associated with a gunshot wound to the head are coded as one injury. In this case the correct code is 116004.5 (Penetrating Injury to Skull, major – Whole Area) or 140692.5 (Penetrating Injury to Cerebrum > 2 cm deep) since we know it is in the temporal lobe. In the case of penetrating injuries to other body regions all underlying injuries are coded separately, however penetrating injuries to the head are coded as one entity unless the coder is sure that the other injuries are not related to the penetrating injury. The best analogy is that of crush injury, where bone, soft tissue and vascular injuries are coded as one entity. Congratulations to Jo for her code and thanks to Paula and Delia for illustrating the many ways that coders often approach these difficult injuries.