Coma scale, best verbal response, none, EMR

This code indicates a Glasgow Coma Scale (GCS) verbal response score of 1 (no verbal response) documented upon a patient's initial presentation to the emergency department. It signifies a severe impairment in the patient's ability to communicate verbally due to an altered mental status.

Apply this code when emergency department documentation explicitly states a GCS verbal score of "none" or "1" at the time of arrival. This is typically seen in cases of severe head trauma, stroke, drug overdose, or other conditions causing profound neurological compromise. The GCS score must be clearly documented by the ED physician or nursing staff.

• Ensure the documentation specifies "at arrival to emergency department" to differentiate from subsequent GCS assessments.
• Do not use this code if the patient is intubated and unable to speak; a GCS verbal score cannot be accurately assessed in such cases.
• Always sequence this code after the primary diagnosis explaining the cause of the altered mental status.