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Compare/P91.5 vs R40.243

P91.5 vs R40.243

P91.5 (Neonatal coma) compared with R40.243 (Glasgow coma scale score 3-8), from the official CMS tabular data. Do not report these codes together: the official tabular list marks them Excludes1.

Can these codes be reported together?

No — do not report together. R40.243 carries an Excludes1 note covering P91.5: “neonatal coma (P91.5)”

Sole exception: when the two conditions are documented as unrelated to each other (ICD-10-CM Official Guidelines, Section I.A.12.a).

Side by side

P91.5Neonatal comaR40.243Glasgow coma scale score 3-8
Billing statusBillableNon-billable header

Report instead: R40.2430, R40.2431, R40.2432, R40.2433, R40.2434

ClassificationP00-P96 — Certain Conditions Originating in the Perinatal Period (P00-P96)R00-R99 — Symptoms, Signs and Abnormal Clinical and Laboratory Findings, Not Elsewhere Classified (R00-R99)
DefinitionNeonatal coma is a billable ICD-10-CM diagnosis code (P91.5).Glasgow coma scale score 3-8 is a non-billable ICD-10-CM category code (R40.243).
7th characterThe following appropriate 7th character is to be added to subcategory R40.24-:
Code first
any associated:
fracture of skull (S02.-)

Derived from the official CMS ICD-10-CM tabular data (FY2026). Not billing advice; verify sequencing rules for the encounter. All data sources