2021 ICD-10-CM Diagnosis Code R40.20

Unspecified coma

    2016 2017 2018 2019 2020 2021 Billable/Specific Code
  • R40.20 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes.
  • The 2021 edition of ICD-10-CM R40.20 became effective on October 1, 2020.
  • This is the American ICD-10-CM version of R40.20 - other international versions of ICD-10 R40.20 may differ.
Applicable To
  • Coma NOS
  • Unconsciousness NOS
The following code(s) above R40.20 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 R40.20:
  • R00-R99
    2021 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
    2021 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 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
  • R40.2
    ICD-10-CM Diagnosis Code R40.2

    Coma

      2016 2017 2018 2019 2020 2021 Non-Billable/Non-Specific Code
    Code First
    • any associated:
    • fracture of skull (S02.-)
    • intracranial injury (S06.-)
    Note
    • One code from each subcategory, R40.21-R40.23, is required to complete the coma scale
    Coma
Approximate Synonyms
  • Acute ischemic stroke with coma
  • Coma
  • Intracerebral hemorrhage with brain compression and coma
  • Intracerebral hemorrhage, coma
  • Ischemic stroke with coma
  • Mental status, unconsciousness
  • Nontraumatic subarachnoid hemorrhage with coma and brain compression
  • Nontraumatic subdural hematoma with brain compression and coma
  • Subarachnoid hemorrhage, with coma
  • Subdural hematoma, with coma
  • Unconscious
  • Unconsciousness
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 level of awareness that can be described as consistently not responsive to stimuli.
  • 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.
  • Loss of the ability to maintain awareness of self and environment combined with markedly reduced responsiveness to environmental stimuli.
  • Loss of the ability to maintain awareness of self and environment combined with markedly reduced responsiveness to environmental stimuli. (from Adams et al., Principles of Neurology, 6th ed, pp344-5)
  • 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.
  • The neurologic status characterized by the occurrence of a loss of the ability to perceive and respond.
ICD-10-CM R40.20 is grouped within Diagnostic Related Group(s) (MS-DRG v38.0):
  • 080 Nontraumatic stupor and coma with mcc
  • 081 Nontraumatic stupor and coma without mcc
  • 791 Prematurity with major problems
  • 793 Full term neonate with major problems

Convert R40.20 to ICD-9-CM

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

Diagnosis Index entries containing back-references to R40.20:

ICD-10-CM Codes Adjacent To R40.20
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
R40.2121 …… in the field [EMT or ambulance]

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