Coding and coverage · ICD-10-CM
R40.223 Coma scale, best verbal response, inappropriate words
This code needs a 7th character (use X as a placeholder for missing characters).
7th character codes
- R40.2230 Coma scale, best verbal response, inappropriate words, unspecified time
- R40.2231 Coma scale, best verbal response, inappropriate words, in the field [EMT or ambulance]
- R40.2232 Coma scale, best verbal response, inappropriate words, at arrival to emergency department
- R40.2233 Coma scale, best verbal response, inappropriate words, at hospital admission
- R40.2234 Coma scale, best verbal response, inappropriate words, 24 hours or more after hospital admission
Instructional notes
Chapter 18
Excludes2Not included here: the patient may have both; report both when both are present.
Notes
- 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.
Section R40-R46
R40.2
Code firstSequence the underlying condition first.
R40.22
7th charactersThe following appropriate 7th character is to be added to subcategory R40.22-:
- 0 unspecified time
- 1 in the field [EMT or ambulance]
- 2 at arrival to emergency department
- 3 at hospital admission
- 4 24 hours or more after hospital admission
This code
Inclusion terms
- Coma scale verbal score of 3
- Inappropriate crying or screaming (< 2 years of age)
- Screaming (2-5 years of age)
Chapter 18: Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified · R40-R46 Symptoms and signs involving cognition, perception, emotional state and behavior (R40-R46)
Source: ICD-10-CM FY 2027 code descriptions and tabular list (CMS and CDC National Center for Health Statistics), effective 2026-10-01 through 2027-09-30 · CMS ICD-10 files. HCC mapping: CMS-HCC V28, payment year 2027. As of 2026-11-04.
Coverage and payment depend on the claim details; confirm with the Medicare Administrative Contractor.