Preparing for a Doctor Visit

The purpose of this document is to provide a useful form to help people potentially suffering from CTE (Chronic traumatic encephalopathy) or PCS (Post-concussion syndrome), and their caregiver, navigate a visit to their healthcare provider. The goal is to provide timely information, and to make that visit as productive and helpful as possible.

Open and print this form in order to be prepared to visit your doctors. Have a helper work with you to fill out the form completely. And if possible have that helper go with you on the appointment. We wish you much success in finding the care you need. If your doctor is not receptive to the information you provide it tells you a lot about the care you will receive. Don’t give up. The right doctor for you is out there.

We are not doctors or scientists. We are an awareness organization. The information we provide is based on our experience in this new frontier and is meant to serve as a tool to aid in seeking recovery.

Click Here to see the Healthcare Navigation Form

ICD-10 Diagnostic codes that doctors can use:

  • S06.8A―Primary blast injury of brain, not elsewhere classified. For veterans, blast injuries to the brain are often called “invisible injuries” because there is no evidence of an external injury on physical examination or routine medical imaging. In a blast, energy from explosive shock waves is transmitted into the brain, causing injury. This can happen with ballistic training.
  • F07.81 for post concessional syndrome. TES (CTE) can fit here if there is a history of repetitive head trauma w/wo concussions.
  • Z87.820 indicates a personal history of traumatic brain injury (TBI). It’s used to document a previous TBI that may influence current care, especially when no other specific TBI codes are applicable.

Please give this to your healthcare provider as well:

https://memory.ucsf.edu/sites/memory.ucsf.edu/files/wysiwyg/UCSF_CTE_Providers_7-13-17.pdf