R40.1 vs R46.4
R40.1 (Stupor) compared with R46.4 (Slowness and poor responsiveness), 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. R46.4 carries an Excludes1 note covering R40.1: “stupor (R40.1)”
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
| R40.1Stupor | R46.4Slowness and poor responsiveness | |
|---|---|---|
| Billing status | Billable | Billable |
| Classification | R00-R99 — Symptoms, Signs and Abnormal Clinical and Laboratory Findings, Not Elsewhere Classified (R00-R99) | R00-R99 — Symptoms, Signs and Abnormal Clinical and Laboratory Findings, Not Elsewhere Classified (R00-R99) |
| Definition | Stupor is a billable ICD-10-CM diagnosis code (R40.1). | Slowness and poor responsiveness is a billable ICD-10-CM diagnosis code (R46.4). |
| Includes | Catatonic stupor Semicoma | — |
Derived from the official CMS ICD-10-CM tabular data (FY2026). Not billing advice; verify sequencing rules for the encounter. All data sources