2022 ICD-10-CM Diagnosis Code R40.2

Coma

    2016 2017 2018 2019 2020 2021 2022 Non-Billable/Non-Specific Code
  • R40.2 should not be used for reimbursement purposes as there are multiple codes below it that contain a greater level of detail.
  • The 2022 edition of ICD-10-CM R40.2 became effective on October 1, 2021.
  • This is the American ICD-10-CM version of R40.2 - other international versions of ICD-10 R40.2 may differ.
Note
  • One code from each subcategory,
    ICD-10-CM Diagnosis Code R40.21

    Coma scale, eyes open

      2016 2017 2018 2019 2020 2021 2022 Non-Billable/Non-Specific Code
    R40.21-
    ICD-10-CM Diagnosis Code R40.23

    Coma scale, best motor response

      2016 2017 2018 2019 2020 2021 2022 Non-Billable/Non-Specific Code
    R40.23
    , is required to complete the coma scale
Code First
Code First Help
Certain conditions have both an underlying etiology and multiple body system manifestations due to the underlying etiology. For such conditions, ICD-10-CM has a coding convention that requires the underlying condition be sequenced first followed by the manifestation. Wherever such a combination exists there is a "use additional code" note at the etiology code, and a "code first" note at the manifestation code. These instructional notes indicate the proper sequencing order of the codes, etiology followed by manifestation. In most cases the manifestation codes will have in the code title, "in diseases classified elsewhere." Codes with this title are a component of the etiology/manifestation convention. The code title indicates that it is a manifestation code. "In diseases classified elsewhere" codes are never permitted to be used as first listed or principle diagnosis codes. They must be used in conjunction with an underlying condition code and they must be listed following the underlying condition.
  • any associated:
  • fracture of skull (
    ICD-10-CM Diagnosis Code S02
    • S02.0 Fracture of vault of skull
    • S02.1 Fracture of base of skull
    • S02.2 Fracture of nasal bones
    • S02.3 Fracture of orbital floor
    • S02.4 Fracture of malar, maxillary and zygoma bones
    • S02.5 Fracture of tooth (traumatic)
    • S02.6 Fracture of mandible
    • S02.8 Fractures of other specified skull and facial bones
    • S02.9 Fracture of unspecified skull and facial bones
    S02.-
    )
  • intracranial injury (
    ICD-10-CM Diagnosis Code S06
    • S06.0 Concussion
    • S06.1 Traumatic cerebral edema
    • S06.2 Diffuse traumatic brain injury
    • S06.3 Focal traumatic brain injury
    • S06.4 Epidural hemorrhage
    • S06.5 Traumatic subdural hemorrhage
    • S06.6 Traumatic subarachnoid hemorrhage
    • S06.8 Other specified intracranial injuries
    • S06.9 Unspecified intracranial injury
    • S06.A Traumatic brain compression and herniation
    S06.-
    )
The following code(s) above R40.2 contain annotation back-references
Annotation Back-References
In this context, annotation back-references refer to codes that contain:
  • Applicable To annotations, or
  • Code Also annotations, or
  • Code First annotations, or
  • Excludes1 annotations, or
  • Excludes2 annotations, or
  • Includes annotations, or
  • Note annotations, or
  • Use Additional annotations
that may be applicable to R40.2:
  • R00-R99
    2022 ICD-10-CM Range R00-R99

    Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified

    Note
    • This chapter includes symptoms, signs, abnormal results of clinical or other investigative procedures, and ill-defined conditions regarding which no diagnosis classifiable elsewhere is recorded.
    • Signs and symptoms that point rather definitely to a given diagnosis have been assigned to a category in other chapters of the classification. In general, categories in this chapter include the less well-defined conditions and symptoms that, without the necessary study of the case to establish a final diagnosis, point perhaps equally to two or more diseases or to two or more systems of the body. Practically all categories in the chapter could be designated 'not otherwise specified', 'unknown etiology' or 'transient'. The Alphabetical Index should be consulted to determine which symptoms and signs are to be allocated here and which to other chapters. The residual subcategories, numbered .8, are generally provided for other relevant symptoms that cannot be allocated elsewhere in the classification.
    • The conditions and signs or symptoms included in categories R00-R94 consist of:
    • (a) cases for which no more specific diagnosis can be made even after all the facts bearing on the case have been investigated;
    • (b) signs or symptoms existing at the time of initial encounter that proved to be transient and whose causes could not be determined;
    • (c) provisional diagnosis in a patient who failed to return for further investigation or care;
    • (d) cases referred elsewhere for investigation or treatment before the diagnosis was made;
    • (e) cases in which a more precise diagnosis was not available for any other reason;
    • (f) certain symptoms, for which supplementary information is provided, that represent important problems in medical care in their own right.
    Type 2 Excludes
    • abnormal findings on antenatal screening of mother (O28.-)
    • certain conditions originating in the perinatal period (P04-P96)
    • signs and symptoms classified in the body system chapters
    • signs and symptoms of breast (N63, N64.5)
    Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified
  • R40-R46
    2022 ICD-10-CM Range R40-R46

    Symptoms and signs involving cognition, perception, emotional state and behavior

    Type 2 Excludes
    • symptoms and signs constituting part of a pattern of mental disorder (F01-F99)
    Symptoms and signs involving cognition, perception, emotional state and behavior
  • R40
    ICD-10-CM Diagnosis Code R40

    Somnolence, stupor and coma

      2016 2017 2018 2019 2020 2021 2022 Non-Billable/Non-Specific Code
    Type 1 Excludes
    • neonatal coma (P91.5)
    • somnolence, stupor and coma in diabetes (E08-E13)
    • somnolence, stupor and coma in hepatic failure (K72.-)
    • somnolence, stupor and coma in hypoglycemia (nondiabetic) (E15)
    Somnolence, stupor and coma
Clinical Information
  • A coma is a deep state of unconsciousness. An individual in a coma is alive but unable to move or respond to his or her environment. Coma may occur as a complication of an underlying illness, or as a result of injuries, such as head trauma.a coma rarely lasts more than 2 to 4 weeks. The outcome for coma depends on the cause, severity, and site of the damage. People may come out of a coma with physical, intellectual, and psychological problems. Some people may remain in a coma for years or even decades. For those people, the most common cause of death is infection, such as pneumonia.
  • A condition in which a patient is in a state of deep sleep and cannot be awakened. A coma may be caused by many things, including trauma, drugs, toxins, or certain diseases.
  • A profound state of unconsciousness associated with depressed cerebral activity from which the individual cannot be aroused. Coma generally occurs when there is dysfunction or injury involving both cerebral hemispheres or the brain stem reticular formation.
  • A state of profound unconsciousness associated with markedly depressed cerebral activity. Causes include central nervous system damage, intoxication, and metabolic abnormalities.
  • Profound state of unconsciousness associated with depressed cerebral activity from which the individual cannot be aroused; coma generally occurs when there is dysfunction or injury involving both cerebral hemispheres or the brain stem.
Code History
  • 2016 (effective 10/1/2015): New code (first year of non-draft ICD-10-CM)
  • 2017 (effective 10/1/2016): No change
  • 2018 (effective 10/1/2017): No change
  • 2019 (effective 10/1/2018): No change
  • 2020 (effective 10/1/2019): No change
  • 2021 (effective 10/1/2020): No change
  • 2022 (effective 10/1/2021): No change
Code annotations containing back-references to R40.2:
  • Type 1 Excludes: R40.0
    , R40.1
    , R55
    ICD-10-CM Diagnosis Code R40.0

    Somnolence

      2016 2017 2018 2019 2020 2021 2022 Billable/Specific Code
    Applicable To
    • Drowsiness
    Type 1 Excludes
    ICD-10-CM Diagnosis Code R40.1

    Stupor

      2016 2017 2018 2019 2020 2021 2022 Billable/Specific Code
    Applicable To
    • Catatonic stupor
    • Semicoma
    Type 1 Excludes
    ICD-10-CM Diagnosis Code R55

    Syncope and collapse

      2016 2017 2018 2019 2020 2021 2022 Billable/Specific Code
    Applicable To
    • Blackout
    • Fainting
    • Vasovagal attack
    Type 1 Excludes
    • cardiogenic shock (R57.0)
    • carotid sinus syncope (G90.01)
    • heat syncope (T67.1)
    • neurocirculatory asthenia (F45.8)
    • neurogenic orthostatic hypotension (G90.3)
    • orthostatic hypotension (I95.1)
    • postprocedural shock (T81.1-)
    • psychogenic syncope (F48.8)
    • shock NOS (R57.9)
    • shock complicating or following abortion or ectopic or molar pregnancy (O00-O07, O08.3)
    • shock complicating or following labor and delivery (O75.1)
    • Stokes-Adams attack (I45.9)
    • unconsciousness NOS (R40.2-)
ICD-10-CM Codes Adjacent To R40.2
R39.8 Other symptoms and signs involving the genitourinary system
R39.81 Functional urinary incontinence
R39.82 Chronic bladder pain
R39.83 Unilateral non-palpable testicle
R39.84 Bilateral non-palpable testicles
R39.89 Other symptoms and signs involving the genitourinary system
R39.9 Unspecified symptoms and signs involving the genitourinary system
R40 Somnolence, stupor and coma
R40.0 Somnolence
R40.1 Stupor
R40.2 Coma
R40.20 Unspecified coma
R40.21 Coma scale, eyes open
R40.211 Coma scale, eyes open, never
R40.2110 …… unspecified time
R40.2111 …… in the field [EMT or ambulance]
R40.2112 …… at arrival to emergency department
R40.2113 …… at hospital admission
R40.2114 …… 24 hours or more after hospital admission
R40.212 Coma scale, eyes open, to pain
R40.2120 …… unspecified time

Reimbursement claims with a date of service on or after October 1, 2015 require the use of ICD-10-CM codes.