R40.22 vs R40.2A
R40.22 (Coma scale, best verbal response) compared with R40.2A (Nontraumatic coma due to underlying condition), 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. R40.2A carries an Excludes1 note covering R40.22: “coma scale, best verbal response (R40.22.-)”
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
| R40.22Coma scale, best verbal response | R40.2ANontraumatic coma due to underlying condition | |
|---|---|---|
| Billing status | Non-billable header Report instead: R40.2210, R40.2211, R40.2212, R40.2213, R40.2214 | 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 | Coma scale, best verbal response is a non-billable ICD-10-CM category code (R40.22). | Nontraumatic coma due to underlying condition is a billable ICD-10-CM diagnosis code (R40.2A). |
| 7th character | The following appropriate 7th character is to be added to subcategory R40.22-: | — |
| Includes | — | Secondary coma |
| Code first | any associated: fracture of skull (S02.-) | underlying condition any associated: |
Derived from the official CMS ICD-10-CM tabular data (FY2026). Not billing advice; verify sequencing rules for the encounter. All data sources