In simple words: A focal brain injury is like a bruise on a specific part of your brain from a head injury. It can cause problems depending on where the injury is located in the brain.

Focal traumatic brain injury refers to a localized injury to the brain tissue caused by direct impact or focused force. This is distinct from diffuse brain injury, which affects a wider area.It's characterized by damage to a specific region of the brain, leading to symptoms associated with the functions controlled by that area.Additional codes should be used for associated conditions like traumatic brain compression or herniation (S06.A-), open wounds of the head (S01.-), or skull fractures (S02.-).This code excludes focal cerebral edema (S06.1) and other specified intracranial injuries (S06.4-S06.6).

Example 1: A patient falls and hits their head, resulting in a localized contusion in the frontal lobe confirmed by CT scan. They present with personality changes and difficulty with executive functions.This would be coded as S06.3., A baseball player is struck in the temple by a pitch, leading to a focal injury affecting the temporal lobe. The patient experiences difficulties with speech comprehension.This scenario would be coded as S06.3, with an additional code from Chapter 20 to specify the external cause (e.g., W21.0 for struck by baseball)., A car accident victim suffers a coup-contrecoup injury resulting in focal damage to both the frontal and occipital lobes. They exhibit both cognitive impairments and visual disturbances. This would be coded as S06.3, along with codes from Chapter 20 specifying the external cause (e.g., V49.49XA for car occupant injured in collision with other and unspecified motor vehicles in traffic accident, initial encounter).

Documentation should include details of the injury mechanism, location and nature of the brain injury based on imaging studies, neurological examination findings (including Glasgow Coma Scale score), and associated symptoms.