Coma scale, best motor response, extension, in the field

This code indicates a specific finding during a neurological assessment using the Glasgow Coma Scale (GCS). It signifies that the patient's best motor response was extension to painful stimuli, as documented by emergency medical personnel in the pre-hospital setting. This finding suggests a significant level of neurological impairment.

This code is used when documentation from emergency medical services (EMS) or ambulance records clearly states a GCS motor score of 2, specifically identifying "extension" as the best motor response. It applies to patients assessed in the field prior to hospital arrival. The documentation must explicitly state the assessment was performed by EMTs or paramedics.

• Ensure the documentation specifies "in the field" or "pre-hospital" assessment by EMS.
• Do not use if the GCS assessment was performed upon arrival at the emergency department or by hospital staff.
• This code should be sequenced after the primary diagnosis related to the patient's altered mental status or injury.