Is R46.5 a billable ICD-10-CM code?

Yes. R46.5 is a billable, specific ICD-10-CM code and is valid for submission on a claim.

Where does R46.5 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 R46.5?

R46.5 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 R46.5 (R46) and apply to it just the same.

R46.5

R46.5 — Suspiciousness and marked evasiveness

Billable / specific codeICD-10-CM

R46.5 is a billable, specific ICD-10-CM code for suspiciousness and marked evasiveness. It is valid for submission on a claim.

Excludes1 inherited from the categories above R46.5

These are not written on R46.5, but they bind it: a note on a category applies to every code beneath it. Billing R46.5 with anything listed here is a denial.

Written on R46 — Symptoms and signs involving appearance and behavior

appearance and behavior in schizophrenia, schizotypal and delusional disorders (F20-F29)
mental and behavioral disorders (F01-F99)

Risk adjustment

R46.5 does not map to an HCC and does not risk-adjust under CMS-HCC V28. That is normal — most ICD-10 codes do not. It still needs to be coded correctly; it just will not move a RAF score.

Medicare coverage

R46.5 is named in 1 Medicare coverage policy — 1 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.

A57130Billing and Coding: Psychiatric Codes

How R46.5 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 R46.5.

Behavior›marked evasiveness
Behavior›suspiciousness

Code history

R46.5 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 R46. If R46.5 is not quite right, the correct code is usually one of these.

Questions about R46.5

Is R46.5 a billable ICD-10-CM code?: Yes. R46.5 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
Where does R46.5 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 R46.5?: R46.5 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 R46.5 (R46) and apply to it just the same.