ICD-10 · PDGM grouping
R40-R46 — Symptoms and signs involving cognition, perception, emotional state and behavior
Every ICD-10-CM code in this range and the PDGM clinical group CMS assigns to it, read from the CMS grouper crosswalk v07.2.26.
ICD-10-CM FY2027 · CMS grouper v07.2.26
Codes in range
157
No clinical group
156
A period cannot be grouped from these.
Barred as primary
96
CMS rejects these in the primary position.
Where these codes group
1 of the 157 codes in R40-R46 group to Behavioral Health. A further 156 are assigned no clinical group at all, which means a 30-day period cannot be grouped from them.
Code families in R40-R46
One page per three-character family: every code in it, whether it can lead a claim, its clinical group and comorbidity subgroup.
- R40Somnolence, stupor and coma101 codes
- R41Other symptoms and signs involving cognitive functions and awareness16 codes
- R42Dizziness and giddiness1 code
- R43Disturbances of smell and taste5 codes
- R44Other symptoms and signs involving general sensations and perceptions6 codes
- R45Symptoms and signs involving emotional state18 codes
- R46Symptoms and signs involving appearance and behavior10 codes
Every code in R40-R46
Descriptions are CMS’s own, abbreviated as CMS abbreviates them.
| Code | Description | Clinical group | Primary position |
|---|---|---|---|
| R400 | Somnolence | None | Cannot lead a claim |
| R401 | Stupor | None | Cannot lead a claim |
| R4020 | Unspecified coma | None | Cannot lead a claim |
| R402110 | Coma scale, eyes open, never, unspecified time | None | Cannot lead a claim |
| R402111 | Coma scale, eyes open, never, in the field | None | Cannot lead a claim |
| R402112 | Coma scale, eyes open, never, EMR | None | Cannot lead a claim |
| R402113 | Coma scale, eyes open, never, at hospital admission | None | Cannot lead a claim |
| R402114 | Coma scale, eyes open, never, 24+hrs | None | Cannot lead a claim |
| R402120 | Coma scale, eyes open, to pain, unspecified time | None | Cannot lead a claim |
| R402121 | Coma scale, eyes open, to pain, in the field | None | Cannot lead a claim |
| R402122 | Coma scale, eyes open, to pain, EMR | None | Cannot lead a claim |
| R402123 | Coma scale, eyes open, to pain, at hospital admission | None | Cannot lead a claim |
| R402124 | Coma scale, eyes open, to pain, 24+hrs | None | Cannot lead a claim |
| R402130 | Coma scale, eyes open, to sound, unspecified time | None | Cannot lead a claim |
| R402131 | Coma scale, eyes open, to sound, in the field | None | Cannot lead a claim |
| R402132 | Coma scale, eyes open, to sound, EMR | None | Cannot lead a claim |
| R402133 | Coma scale, eyes open, to sound, at hospital admission | None | Cannot lead a claim |
| R402134 | Coma scale, eyes open, to sound, 24+hrs | None | Cannot lead a claim |
| R402140 | Coma scale, eyes open, spontaneous, unspecified time | None | Cannot lead a claim |
| R402141 | Coma scale, eyes open, spontaneous, in the field | None | Cannot lead a claim |
| R402142 | Coma scale, eyes open, spontaneous, EMR | None | Cannot lead a claim |
| R402143 | Coma scale, eyes open, spontaneous, at hospital admission | None | Cannot lead a claim |
| R402144 | Coma scale, eyes open, spontaneous, 24+hrs | None | Cannot lead a claim |
| R402210 | Coma scale, best verbal response, none, unspecified time | None | Cannot lead a claim |
| R402211 | Coma scale, best verbal response, none, in the field | None | Cannot lead a claim |
| R402212 | Coma scale, best verbal response, none, EMR | None | Cannot lead a claim |
| R402213 | Coma scale, best verbal response, none, admit | None | Cannot lead a claim |
| R402214 | Coma scale, best verbal response, none, 24+hrs | None | Cannot lead a claim |
| R402220 | Coma scale, best verb, incomprehensible words, unsp time | None | Cannot lead a claim |
| R402221 | Coma scale, best verb, incomprehensible words, in the field | None | Cannot lead a claim |
| R402222 | Coma scale, best verb, incomprehensible words, EMR | None | Cannot lead a claim |
| R402223 | Coma scale, best verb, incomprehensible words, admit | None | Cannot lead a claim |
| R402224 | Coma scale, best verb, incomprehensible words, 24+hrs | None | Cannot lead a claim |
| R402230 | Coma scale, best verb, inappropriate words, unsp time | None | Cannot lead a claim |
| R402231 | Coma scale, best verb, inappropriate words, in the field | None | Cannot lead a claim |
| R402232 | Coma scale, best verbal response, inappropriate words, EMR | None | Cannot lead a claim |
| R402233 | Coma scale, best verbal response, inappropriate words, admit | None | Cannot lead a claim |
| R402234 | Coma scale, best verb, inappropriate words, 24+hrs | None | Cannot lead a claim |
| R402240 | Coma scale, best verb, confused conversation, unsp time | None | Cannot lead a claim |
| R402241 | Coma scale, best verb, confused conversation, in the field | None | Cannot lead a claim |
| R402242 | Coma scale, best verbal response, confused conversation, EMR | None | Cannot lead a claim |
| R402243 | Coma scale, best verb, confused conversation, admit | None | Cannot lead a claim |
| R402244 | Coma scale, best verb, confused conversation, 24+hrs | None | Cannot lead a claim |
| R402250 | Coma scale, best verbal response, oriented, unspecified time | None | Cannot lead a claim |
| R402251 | Coma scale, best verbal response, oriented, in the field | None | Cannot lead a claim |
| R402252 | Coma scale, best verbal response, oriented, EMR | None | Cannot lead a claim |
| R402253 | Coma scale, best verbal response, oriented, admit | None | Cannot lead a claim |
| R402254 | Coma scale, best verbal response, oriented, 24+hrs | None | Cannot lead a claim |
| R402310 | Coma scale, best motor response, none, unspecified time | None | Cannot lead a claim |
| R402311 | Coma scale, best motor response, none, in the field | None | Cannot lead a claim |
| R402312 | Coma scale, best motor response, none, EMR | None | Cannot lead a claim |
| R402313 | Coma scale, best motor response, none, at hospital admission | None | Cannot lead a claim |
| R402314 | Coma scale, best motor response, none, 24+hrs | None | Cannot lead a claim |
| R402320 | Coma scale, best motor response, extension, unspecified time | None | Cannot lead a claim |
| R402321 | Coma scale, best motor response, extension, in the field | None | Cannot lead a claim |
| R402322 | Coma scale, best motor response, extension, EMR | None | Cannot lead a claim |
| R402323 | Coma scale, best motor response, extension, admit | None | Cannot lead a claim |
| R402324 | Coma scale, best motor response, extension, 24+hrs | None | Cannot lead a claim |
| R402330 | Coma scale, best motor, abnormal flexion, unspecified time | None | Cannot lead a claim |
| R402331 | Coma scale, best motor, abnormal flexion, in the field | None | Cannot lead a claim |
| R402332 | Coma scale, best motor response, abnormal flexion, EMR | None | Cannot lead a claim |
| R402333 | Coma scale, best motor response, abnormal flexion, admit | None | Cannot lead a claim |
| R402334 | Coma scale, best motor response, abnormal flexion, 24+hrs | None | Cannot lead a claim |
| R402340 | Coma scale, best motor, flexion withdrawal, unsp time | None | Cannot lead a claim |
| R402341 | Coma scale, best motor, flexion withdrawal, in the field | None | Cannot lead a claim |
| R402342 | Coma scale, best motor response, flexion withdrawal, EMR | None | Cannot lead a claim |
| R402343 | Coma scale, best motor response, flexion withdrawal, admit | None | Cannot lead a claim |
| R402344 | Coma scale, best motor response, flexion withdrawal, 24+hrs | None | Cannot lead a claim |
| R402350 | Coma scale, best motor response, localizes pain, unsp time | None | Cannot lead a claim |
| R402351 | Coma scale, best motor, localizes pain, in the field | None | Cannot lead a claim |
| R402352 | Coma scale, best motor response, localizes pain, EMR | None | Cannot lead a claim |
| R402353 | Coma scale, best motor response, localizes pain, admit | None | Cannot lead a claim |
| R402354 | Coma scale, best motor response, localizes pain, 24+hrs | None | Cannot lead a claim |
| R402360 | Coma scale, best motor response, obeys commands, unsp time | None | Cannot lead a claim |
| R402361 | Coma scale, best motor, obeys commands, in the field | None | Cannot lead a claim |
| R402362 | Coma scale, best motor response, obeys commands, EMR | None | Cannot lead a claim |
| R402363 | Coma scale, best motor response, obeys commands, admit | None | Cannot lead a claim |
| R402364 | Coma scale, best motor response, obeys commands, 24+hrs | None | Cannot lead a claim |
| R402410 | Glasgow coma scale score 13-15, unspecified time | None | Cannot lead a claim |
| R402411 | Glasgow coma scale score 13-15, in the field | None | Cannot lead a claim |
| R402412 | Glasgow coma scale score 13-15, EMR | None | Cannot lead a claim |
| R402413 | Glasgow coma scale score 13-15, at hospital admission | None | Cannot lead a claim |
| R402414 | Glasgow coma scale score 13-15, 24+hrs | None | Cannot lead a claim |
| R402420 | Glasgow coma scale score 9-12, unspecified time | None | Cannot lead a claim |
| R402421 | Glasgow coma scale score 9-12, in the field | None | Cannot lead a claim |
| R402422 | Glasgow coma scale score 9-12, EMR | None | Cannot lead a claim |
| R402423 | Glasgow coma scale score 9-12, at hospital admission | None | Cannot lead a claim |
| R402424 | Glasgow coma scale score 9-12, 24+hrs | None | Cannot lead a claim |
| R402430 | Glasgow coma scale score 3-8, unspecified time | None | Cannot lead a claim |
| R402431 | Glasgow coma scale score 3-8, in the field | None | Cannot lead a claim |
| R402432 | Glasgow coma scale score 3-8, EMR | None | Cannot lead a claim |
| R402433 | Glasgow coma scale score 3-8, at hospital admission | None | Cannot lead a claim |
| R402434 | Glasgow coma scale score 3-8, 24+hrs | None | Cannot lead a claim |
| R402440 | Other coma, without Glasgow, or w/part score, unsp time | None | Cannot lead a claim |
| R402441 | Other coma, without Glasgow, or w/part score, in the field | None | Cannot lead a claim |
| R402442 | Other coma, without documented Glasgow, or w/part score, EMR | None | Cannot lead a claim |
| R402443 | Other coma, without Glasgow, or w/part score, admit | None | Cannot lead a claim |
| R402444 | Other coma, without Glasgow, or w/part score, 24+hrs | None | Cannot lead a claim |
| R402A | Nontraumatic coma due to underlying condition | None | Cannot lead a claim |
| R403 | Persistent vegetative state | None | Cannot lead a claim |
| R404 | Transient alteration of awareness | None | Cannot lead a claim |
| R410 | Disorientation, unspecified | None | Cannot lead a claim |
| R411 | Anterograde amnesia | None | Cannot lead a claim |
| R412 | Retrograde amnesia | None | Cannot lead a claim |
| R413 | Other amnesia | None | Cannot lead a claim |
| R414 | Neurologic neglect syndrome | None | Cannot lead a claim |
| R4181 | Age-related cognitive decline | None | Cannot lead a claim |
| R4182 | Altered mental status, unspecified | None | Cannot lead a claim |
| R4183 | Borderline intellectual functioning | None | Cannot lead a claim |
| R41840 | Attention and concentration deficit | None | Cannot lead a claim |
| R41841 | Cognitive communication deficit | None | Cannot lead a claim |
| R41842 | Visuospatial deficit | None | Cannot lead a claim |
| R41843 | Psychomotor deficit | None | Cannot lead a claim |
| R41844 | Frontal lobe and executive function deficit | None | Cannot lead a claim |
| R4185 | Anosognosia | None | Cannot lead a claim |
| R4189 | Oth symptoms and signs w cognitive functions and awareness | None | Cannot lead a claim |
| R419 | Unsp symptoms and signs w cognitive functions and awareness | None | Cannot lead a claim |
| R42 | Dizziness and giddiness | None | Cannot lead a claim |
| R430 | Anosmia | None | Cannot lead a claim |
| R431 | Parosmia | None | Cannot lead a claim |
| R432 | Parageusia | None | Cannot lead a claim |
| R438 | Other disturbances of smell and taste | None | Cannot lead a claim |
| R439 | Unspecified disturbances of smell and taste | None | Cannot lead a claim |
| R440 | Auditory hallucinations | None | Cannot lead a claim |
| R441 | Visual hallucinations | None | Cannot lead a claim |
| R442 | Other hallucinations | None | Cannot lead a claim |
| R443 | Hallucinations, unspecified | None | Cannot lead a claim |
| R448 | Oth symptoms and signs w general sensations and perceptions | None | Cannot lead a claim |
| R449 | Unsp symptoms and signs w general sensations and perceptions | None | Cannot lead a claim |
| R450 | Nervousness | None | Cannot lead a claim |
| R451 | Restlessness and agitation | None | Cannot lead a claim |
| R452 | Unhappiness | None | Cannot lead a claim |
| R453 | Demoralization and apathy | None | Cannot lead a claim |
| R454 | Irritability and anger | None | Cannot lead a claim |
| R455 | Hostility | None | Cannot lead a claim |
| R456 | Violent behavior | None | Cannot lead a claim |
| R457 | State of emotional shock and stress, unspecified | None | Cannot lead a claim |
| R4581 | Low self-esteem | None | Cannot lead a claim |
| R4582 | Worries | None | Cannot lead a claim |
| R4583 | Excessive crying of child, adolescent or adult | None | Cannot lead a claim |
| R4584 | Anhedonia | None | Cannot lead a claim |
| R45850 | Homicidal ideations | None | Cannot lead a claim |
| R45851 | Suicidal ideations | None | Cannot lead a claim |
| R4586 | Emotional lability | None | Cannot lead a claim |
| R4587 | Impulsiveness | None | Cannot lead a claim |
| R4588 | Nonsuicidal self-harm | F | Can lead a claim |
| R4589 | Other symptoms and signs involving emotional state | None | Cannot lead a claim |
| R460 | Very low level of personal hygiene | None | Cannot lead a claim |
| R461 | Bizarre personal appearance | None | Cannot lead a claim |
| R462 | Strange and inexplicable behavior | None | Cannot lead a claim |
| R463 | Overactivity | None | Cannot lead a claim |
| R464 | Slowness and poor responsiveness | None | Cannot lead a claim |
| R465 | Suspiciousness and marked evasiveness | None | Cannot lead a claim |
| R466 | Undue concern and preoccupation with stressful events | None | Cannot lead a claim |
| R467 | Verbosity and circumstantial detail obscuring rsn for cntct | None | Cannot lead a claim |
| R4681 | Obsessive-compulsive behavior | None | Cannot lead a claim |
| R4689 | Other symptoms and signs involving appearance and behavior | None | Cannot lead a claim |
Source: CMS HH PPS Grouper Software v07.2.26, effective 2026-10-01. This is the crosswalk Medicare runs a claim through. Grouping also depends on admission source, timing, the OASIS functional items and the rest of the diagnosis list.
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