A: If the patient has an anatomic injury to the brain (e.g. SDH, IVH, SAH, etc.) in addition to LOC, the LOC will only be acknowledged by AIS if there is a coma modifier listed with the injury, such as is found with several injuries on page 48 of the AIS 2008 dictionary. If the patient has a different type of brain injury, for example SDH with LOC, there is no coma modifier listed with SDH so the LOC will be “lost” for AIS coding purposes and LOC is not coded additionally. (Remember too that in AIS 2008 LOC/coma can only be assigned to one injury [rule page 40] so if you have two injuries with coma modifiers, use the one that provides the highest AIS value for coma and code the other as NFS.)