Traumatic contusion or haematoma S003

Current RMA Instruments

Changes from previous Instruments

ICD Coding

ICD-10-AM Codes: H11.3, S00, S20, S30, S40, S50, S60, S70, S80, S90, T11.05, T13.05, T14.05

Brief description

A traumatic contusion or haematoma (bruise) refers to a localised collection of blood within the skin, tissue or organ as a result of a direct blow or injury. This physical force causes tissue damage and internal bleeding. Some traumatic contusions or haemorrhage can continue to enlarge due to persistent bleeding. Traumatic contusions can affect various structures, including organs such as the heart, pericardium, and lungs. 

In some cases, haematomas may compress surrounding structures such as nerves and blood vessels. An acute compartment syndrome secondary to blood collection is also considered an integral manifestation of a traumatic contusion.

Confirming the diagnosis

The diagnosis can be made, based on the clinical examination, by a medical practitioner. Imaging tests may be requested to assess for more serious injuries but these investigations are not required for confirmation of this diagnosis. 

Diagnoses covered by these SOPs

• Contusion of organs including the heart, pericardium, lung, pleura, liver, spleen, and kidneys
• Contusions of bone
• Contusions of joints
• Contusion of the eye or orbit
• Conjunctival (subconjuctival) haemorrhage
• Scleral haemorrhage (of the eye)
• Contusion of skin or subcutaneous tissues
• Haematoma of skin or subcutaneous tissues

Conditions not covered by these SOPs

• Blood collection/haematoma in an internal organ *
• Blood collection/haematoma associated with a fracture *
• Blood collection/haematoma associated with muscle injury #
• Blood collection associated with subarachnoid haemorrhage #
• Blood collection associated with subdural haemorrhage #
• Blood collection associated with extradural haemorrhage #
• Cerebrovascular accident #
• Moderate to severe traumatic brain injury * - if traumatic haematoma is only affecting the brain, then the moderate to severe traumatic brain injury SoP should be applied

* another SoP applies  - the SoP has the same name unless otherwise specified

# non-SOP condition

Clinical onset

The clinical date of onset corresponds to the day of the injury. Symptoms are typically consistent with bruising, characterised by discoloration of the skin at the affected site- commonly appearing purple, blue or black- due to the accumulation of blood under the skin. There is often associated swelling, tenderness and reported pain. 

Clinical worsening

Contusions or bruises typically resolve without complications within days to weeks with simple supportive care. however, more severe contusions or larger haematomas may take longer to heal and may occasionally require drainage. In some cases, severe contusions can lead to complications such as compartment syndrome, where increased pressure within the affected muscle compartments restricts blood flow, potentially resulting in tissue damage.