R40.224

R40.224: Coma scale, best verbal response, confused conversation

Non-billable headerICD-10-CM

R40.224 is a non-billable header ICD-10-CM code for coma scale, best verbal response, confused conversation. It cannot be billed on its own: choose one of the more specific child codes below. This code also requires a 7th character before it is complete.

This code requires a 7th character

The 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

Inclusion terms

Alternative wordings a physician may use in the chart for this same code.

Coma scale verbal score of 4
Inappropriate words (2-5 years of age)
Irritable cries (< 2 years of age)

Excludes1 inherited from the categories above R40.224

A category’s note binds every code beneath it.

Written on R40: Somnolence, stupor and coma

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)

Other codes that can never be billed with R40.224

Their own Excludes1 notes name this code, so the conflict is not listed above.

R41.82Altered mental status, unspecified

Risk adjustment

No CMS-HCC V28 category: this code does not change a RAF score.

Alphabetic index entries that lead here

Coma›with›verbal response›confused conversation
Coma›with›verbal response›inappropriate words(2-5 years of age)
Coma›with›verbal response›irritable cries(< 2 years of age)
Coma›with›verbal response›score of›4

Code history

Unchanged in every release from FY2024 to FY2027.

Code to one of these instead R40.224

5 child codes. Green means billable.