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R40.3

R40.3Persistent vegetative state

Billable / specific codeICD-10-CM

R40.3 is a billable, specific ICD-10-CM code for persistent vegetative state. It is valid for submission on a claim.

Excludes1 inherited from the categories above R40.3

These are not written on R40.3, but they bind it: a note on a category applies to every code beneath it. Billing R40.3 with anything listed here is a denial.

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 R40.3

These codes carry an Excludes1 note pointing at R40.3. The conflict binds both ways, but ICD-10-CM only writes it down on one side — so you would not find this by reading R40.3 alone.

  • R41.82Altered mental status, unspecified

Risk adjustment

R40.3 risk-adjusts. Under the CMS-HCC V28 model it maps to this category:

  • HCC 202 Coma, Brain Compression/Anoxic Damage0.543 RAF

Coefficient shown for the Community Non-dual Aged segment. A higher HCC in the same hierarchy will suppress this one, so capturing it does not always add score.

Medicare coverage

R40.3 is named in 5 Medicare coverage policies 5 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.

  • A56612Billing and Coding: CT of the Head
  • A56625Billing and Coding: Echocardiography
  • A56773Billing and Coding: Neurophysiology Evoked Potentials (NEPs)
  • A57204Billing and Coding: MRI and CT Scans of the Head and Neck

How R40.3 is indexed

Coders do not find codes by browsing the tabular list — they look them up in the alphabetic index, under the word the physician wrote. These are the index entries that lead here, so you can see which chart wordings map to R40.3.

  • Comapersistent vegetative state
  • Statepersistent vegetative
  • Statevegetative, persistent

Code history

R40.3 has not changed since FY2024 — no addition, revision or deletion across the three most recent ICD-10-CM releases.

Related codes at this level

Codes that share R40. If R40.3 is not quite right, the correct code is usually one of these.

Questions about R40.3

Is R40.3 a billable ICD-10-CM code?
Yes. R40.3 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
Where does R40.3 sit in the tabular list?
Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R99), in the block Symptoms and signs involving cognition, perception, emotional state and behavior (R40-R46).
What cannot be coded together with R40.3?
R40.3 carries Excludes1 notes, which means the conditions they list can never be coded together with it on the same encounter. Some are written on the categories above R40.3 (R40) and apply to it just the same.
ICD-10-CMFY2026-Apr· effective April 1, 2026

Loaded directly from the CMS/NCHS ICD-10-CM public-domain release — see data sources and our editorial policy. If this page disagrees with the CMS tabular list, this page is wrong. Reference information for professional coders; not medical or billing advice.