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Gunshot injury S026
Current RMA Instruments
|Reasonable Hypothesis SOP||23 of 2020|
|Balance of Probabilities SOP||24 of 2020|
SOP bulletin information for new Instruments
Multiple ICD codes potentially apply depending on the specific nature of the injuries.
- ICD-9-CM Codes: From within the range 851 to 957 (not all codes in this range apply)
- ICD-10-AM Codes: From withIn the range S00 to T07 (not all codes in this range apply)
The gun shot injury SOP covers any physical injury from (being struck by) a non-explosive projectile fired from any type of gun (including a hand gun, rifle, machine gun, or shotgun).
Such injuries may also be covered by other SOPs. The most appropriate SOP for the circumstances of the claim should be applied. More than one SOP may be applicable depending on the specific circumstances. The name of the SOP should not be used as a diagnostic label for claims. The diagnostic label should be changed to one that accurately describes the relevant injury or injuries.
Confirming the diagnosis
The diagnosis can be confirmed based on a record or report from a medical practitioner. Specialist opinion is not required.
Other SOPs that may be relevant for gunshot injury include
- Moderate to severe traumatic brain injury
Conditions not covered by gunshot injury SOP
- Explosive blast injury*
- Acute stress disorder*
- Post traumatic stress disorder*
- Sensorineural hearing loss*
* another SOP applies
Clinical onset is not a term used in any SOP factor for this SOP, but the clinical onset will be at the time of the relevant injury.
The SOP has only an inability to obtain appropriate clinical management factor for clinical worsening. This could only be relevant in the unlikely scenario where the gunshot injury was non-service related, but the treatment provided (for the direct effects of the gunshot) was service-related.