F01 vs R40.225

F01 (Vascular dementia) compared with R40.225 (Coma scale, best verbal response, oriented), from the official CMS tabular data.

Summary

These codes can be reported together when both conditions are documented, because R40.225 lists F01 under Excludes2, which marks them as distinct conditions.

Official rule

What is different?

The conditions named and chapter.F01 is “Vascular dementia”; R40.225 is “Coma scale, best verbal response, oriented”. F01 sits in F01-F99 — Mental, Behavioral and Neurodevelopmental Disorders (F01-F99); R40.225 in R00-R99 — Symptoms, Signs and Abnormal Clinical and Laboratory Findings, Not Elsewhere Classified (R00-R99).

Registry fact

Can these codes be reported together?

Yes, when both are documented.R40.225 lists F01 under Excludes2: “symptoms and signs constituting part of a pattern of mental disorder (F01-F99)”. Excludes2 marks distinct conditions that may both be reported when both are documented.

Official ruleGuide: Excludes1 vs Excludes2

Is there an Excludes1 relationship?

None.Neither entry carries an Excludes1 note that names the other code. R40.225 carries 4 Excludes1 notes covering other codes; the side-by-side table quotes them.

Official rule

Is there an Excludes2 relationship?

Yes.R40.225’s tabular entry: “symptoms and signs constituting part of a pattern of mental disorder (F01-F99)”. The note covers F01.

Official ruleGuide: Excludes1 vs Excludes2

Is one more specific?

Not comparable.The codes sit in different categories; specificity is only comparable within one category.

Is one a parent or header code?

Both are headers.Both are non-billable headers, and neither contains the other.

Registry fact

Are there sequencing instructions?

None.Neither entry carries a Code First or Use Additional Code note that names the other.

Official rule

Are there other coding relationships?

None found.No laterality, encounter-phase, Table of Neoplasms, Table of Drugs and Chemicals, or history-versus-active-disease relationship links these codes.

MedCoder-derived

Official rule: a tabular instructional note or a section of the ICD-10-CM Official Guidelines, quoted as published. Registry fact: the codes’ own published attributes (titles, billable status, position in the hierarchy, code set). MedCoder-derived: a reading MedCoder computes from those facts; it is not itself a rule. How to read the labels

Can these codes be reported together?

Informational

Excludes2 relationship

R40.225

Coma scale, best verbal response, oriented

↔

F01

Vascular dementia

What we found

Yes, when both are documented.R40.225 carries an Excludes2 note covering F01: “symptoms and signs constituting part of a pattern of mental disorder (F01-F99)”

Excludes2 marks distinct conditions — both may be reported when both are documented.

What to review

Report both only when the documentation supports both conditions; otherwise report the one documented.

Guide: Excludes1 vs Excludes2 Check these on a claim

Why it matters

An Excludes2 note means the excluded condition is not part of the code above it, but a patient can have both. Report both when both are documented.

Source / rule

CMS ICD-10-CM tabular instructional notes

Official guidance behind these answers

Section I.A.12.b — Excludes2 · applies to: Excludes2
A type 2 Excludes note represents “Not included here.” An excludes2 note indicates that the condition excluded is not part of the condition represented by the code, but a patient may have both conditions at the same time. When an Excludes2 note appears under a code, it is acceptable to use both the code and the excluded code together, when appropriate.
ICD-10-CM Official Guidelines FY2026

Quoted from the ICD-10-CM Official Guidelines for Coding and Reporting in effect for the release shown. The tabular notes above are the code-level instruction; these sections are the convention that says how such a note is applied. Source document (CMS PDF) · Release and checksum

Side by side

	F01Vascular dementia	R40.225Coma scale, best verbal response, oriented
Billing status	Non-billable header Report instead: F01.50, F01.511, F01.518, F01.52, F01.53	Non-billable header Report instead: R40.2250, R40.2251, R40.2252, R40.2253, R40.2254
Classification	F01-F99 — Mental, Behavioral and Neurodevelopmental Disorders (F01-F99)	R00-R99 — Symptoms, Signs and Abnormal Clinical and Laboratory Findings, Not Elsewhere Classified (R00-R99)
Definition	Vascular dementia is a non-billable ICD-10-CM category code (F01).	Coma scale, best verbal response, oriented is a non-billable ICD-10-CM category code (R40.225).
7th character	—	The following appropriate 7th character is to be added to subcategory R40.22-:
Includes	arteriosclerotic dementia major neurocognitive disorder due to vascular disease multi-infarct dementia Vascular dementia as a result of infarction of the brain due to vascular disease, including hypertensive cerebrovascular disease.	Coma scale verbal score of 5 Cooing or babbling or crying appropriately (< 2 years of age) Uses appropriate words (2- 5 years of age)
Excludes1	—	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)
Excludes2	—	symptoms and signs constituting part of a pattern of mental disorder (F01-F99)
Code first	, if applicable, any causal condition	any associated: fracture of skull (S02.-)

Notes are the code’s own tabular entry, quoted as published. A note that names the other code is the one the verdict above rests on.

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Derived from the official CMS ICD-10-CM tabular data (FY2027). A coding-rule comparison, not billing advice: payer-specific edits and medical-necessity policy are outside its scope. All data sources