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ICD-10/R40.2440

R40.2440 ICD-10-CM Code: Other coma, without documented Glasgow coma scale score, or with partial score reported, unspecified time

Billing Status: YES. This is a valid, specific, and billable ICD-10-CM reference.

Inpatient Payment Groups (MS-DRG)

MS-DRGs this diagnosis helps define, as principal or secondary, per the CMS ICD-10-CM/PCS MS-DRG Definitions Manual v43.0, Appendix B.

  • MS-DRG 951 — OTHER FACTORS INFLUENCING HEALTH STATUS (MDC 23)

A diagnosis appearing in a group's logic does not by itself determine the DRG assigned to a stay; the grouper uses the full claim.

Risk Adjustment (CMS-HCC)

Payment categories this diagnosis maps to under CMS-HCC V28, payment year 2026.

  • HCC 202 — Coma, Brain Compression/Anoxic Damage

Other models: CMS-HCC V22 HCC 80

Risk scores depend on the enrollee's full accepted diagnosis set and segment; a category mapping alone does not determine payment.

Official Registry Overview & Definition

Other coma, without documented Glasgow coma scale score, or with partial score reported, unspecified time is a billable ICD-10-CM diagnosis code (R40.2440).

Official Tabular Instructional Notes

Sequencing, inclusion, and exclusion notes published for R40.2440 in the official ICD-10-CM tabular list.

Excludes1 — Not Coded Here

Conditions generally not reported together with this code (Excludes1) -- an error unless the two conditions are documented as unrelated to each other (ICD-10-CM Official Guidelines, Section I.A.12.a).

Excludes2 — Not Included Here

Conditions not covered by this code, but which may be reported alongside it when both are present.

Code First

Underlying conditions that must be sequenced before this code.

  • any associated:
  • fracture of skull (S02.-)
  • intracranial injury (S06.-)

Change history

  • FY2017 — 2016-10-01
    Added to the code set
    Other coma, without documented Glasgow coma scale score, or with partial score reported, unspecified time
    FY2017 changes

Verify Before Coding

  • Billable — reportable as written.
  • Principal-diagnosis restriction. The Medicare Code Editor lists this code as unacceptable as a principal diagnosis: it describes a circumstance influencing health status rather than a current illness or injury being treated. It is valid as a secondary diagnosis.

From the code registry, the Medicare Code Editor, and the MS-DRG Definitions Manual. Check it against a full claim.

Contextual Map

Every relationship of R40.2440 in one view: hierarchy, official tabular instructions in both directions, clinical classification, risk adjustment, MS-DRG participation, index terms and change history — each edge carrying the CMS source it derives from.

Hierarchy

  • R00-R99 — Chapter 18: Symptoms, Signs and Abnormal Clinical and Laboratory Findings, Not Elsewhere Classified (R00-R99) (R00-R99) [Hierarchy]
  • R40-R46 — Symptoms and signs involving cognition, perception, emotional state and behavior [Hierarchy]

Referenced by Excludes1 notes

  • R40.0 — Somnolence [Excludes1](via R40.2.-): “coma (R40.2-)” · check together
  • R40.1 — Stupor [Excludes1](via R40.2.-): “coma (R40.2-)” · check together
  • R41.82 — Altered mental status, unspecified [Excludes1](via R40.-): “altered level of consciousness (R40.-)” · check together
  • R55 — Syncope and collapse [Excludes1](via R40.2.-): “unconsciousness NOS (R40.2-)” · check together

Referenced by Use Additional Code instructions

  • T65.85 — Toxic effect of medetomidine [Use Additional Code](via R40.-): “somnolence, stupor and coma (R40.-)” · check together
  • T67.0 — Heatstroke and sunstroke [Use Additional Code](via R40.-): “coma and stupor (R40.-)” · check together

Clinical classification (CCSR)

  • SYM010 — Nervous system signs and symptoms [CCSR]

Risk adjustment (CMS-HCC)

  • HCC 202 — Coma, Brain Compression/Anoxic Damage [CMS-HCC]

Potential MS-DRG

  • DRG 951 — OTHER FACTORS INFLUENCING HEALTH STATUS [MS-DRG]: “OTHER FACTORS INFLUENCING HEALTH STATUS (MDC 23)”

MDC crossing · procedures (1235)

  • MDC 23 — Factors Influencing Health Status and Other Contacts with Health Services [MDC crossing]: “Factors Influencing Health Status and Other Contacts with Health Services — the grouper's crossing between diagnoses and procedures: a principal diagnosis sets the MDC, and same-MDC procedures move the stay to its surgical DRGs.”
  • F003GKZ — Communicative/Cognitive Integration Skills Assessment of Neurological System - Whole Body using Audiovisual Equipment [Same-MDC procedure]: “Communicative/Cognitive Integration Skills Assessment of Neurological System - Whole Body using Audiovisual Equipment — grouped in MDC 23, the procedure side of this code's crossing.” · check together
  • F003GMZ — Communicative/Cognitive Integration Skills Assessment of Neurological System - Whole Body using Augmentative / Alternative Communication Equipment [Same-MDC procedure]: “Communicative/Cognitive Integration Skills Assessment of Neurological System - Whole Body using Augmentative / Alternative Communication Equipment — grouped in MDC 23, the procedure side of this code's crossing.” · check together
  • F003GPZ — Communicative/Cognitive Integration Skills Assessment of Neurological System - Whole Body using Computer [Same-MDC procedure]: “Communicative/Cognitive Integration Skills Assessment of Neurological System - Whole Body using Computer — grouped in MDC 23, the procedure side of this code's crossing.” · check together
  • F003GYZ — Communicative/Cognitive Integration Skills Assessment of Neurological System - Whole Body using Other Equipment [Same-MDC procedure]: “Communicative/Cognitive Integration Skills Assessment of Neurological System - Whole Body using Other Equipment — grouped in MDC 23, the procedure side of this code's crossing.” · check together
  • F003GZZ — Communicative/Cognitive Integration Skills Assessment of Neurological System - Whole Body [Same-MDC procedure]: “Communicative/Cognitive Integration Skills Assessment of Neurological System - Whole Body — grouped in MDC 23, the procedure side of this code's crossing.” · check together
  • and 1230 more

Nearest codes (40)

  • R40 — Somnolence, stupor and coma [Sibling]
  • R40.2344 — Coma scale, best motor response, flexion withdrawal, 24 hours or more after hospital admission [Sibling]
  • R40.235 — Coma scale, best motor response, localizes pain [Sibling]
  • R40.2350 — Coma scale, best motor response, localizes pain, unspecified time [Sibling]
  • R40.2351 — Coma scale, best motor response, localizes pain, in the field [EMT or ambulance] [Sibling]
  • R40.2352 — Coma scale, best motor response, localizes pain, at arrival to emergency department [Sibling]
  • R40.2353 — Coma scale, best motor response, localizes pain, at hospital admission [Sibling]
  • R40.2354 — Coma scale, best motor response, localizes pain, 24 hours or more after hospital admission [Sibling]
  • and 32 more

Change history

  • FY2017 — Added to the code set [Change history]

Referenced by Other Codes

Clinical classification (AHRQ CCSR):SYM010 — Nervous system signs and symptoms.

Clinical Classifications Software Refined (CCSR) for ICD-10-CM Diagnoses. Healthcare Cost and Utilization Project (HCUP), Agency for Healthcare Research and Quality.

Potential MS-DRG Relationships (FY2026)

Not on the CMS CC/MCC list — as a secondary diagnosis this code does not change MS-DRG severity.

Named in the grouper logic of 1 MS-DRG: DRG 951 (MDC 23).

From the CMS MS-DRG Definitions Manual (Appendices B and C). Actual DRG assignment depends on the complete claim.

Official ICD-10-CM tabular notes on other codes that name R40.2440 or its code family.

4 Excludes1 notes: R40.0 (via R40.2.-), R40.1 (via R40.2.-), R41.82 (via R40.-), R55 (via R40.2.-).

2 Use Additional Code instructions: T65.85 (via R40.-), T67.0 (via R40.-).

Frequently Asked Questions (FAQ) & Clinical Guidance

Does R40.2440 require a 7th character?

Yes. The following appropriate 7th character is to be added to subcategory R40.24-:.

Nearest Codes in This Family

Official ICD-10-CM classifications closest to R40.2440 in its code family, with their registry titles.

  • R40.2431 — Glasgow coma scale score 3-8, in the field [EMT or ambulance]
  • R40.2432 — Glasgow coma scale score 3-8, at arrival to emergency department
  • R40.2433 — Glasgow coma scale score 3-8, at hospital admission
  • R40.2434 — Glasgow coma scale score 3-8, 24 hours or more after hospital admission
  • R40.244 — Other coma, without documented Glasgow coma scale score, or with partial score reported
  • R40.2441 — Other coma, without documented Glasgow coma scale score, or with partial score reported, in the field [EMT or ambulance]
  • R40.2442 — Other coma, without documented Glasgow coma scale score, or with partial score reported, at arrival to emergency department
  • R40.2443 — Other coma, without documented Glasgow coma scale score, or with partial score reported, at hospital admission
  • R40.2444 — Other coma, without documented Glasgow coma scale score, or with partial score reported, 24 hours or more after hospital admission
  • R40.2A — Nontraumatic coma due to underlying condition

View all codes in the R40 family