F32 vs R40.1
F32 and R40.1 can never be reported together. ICD-10-CM declares them mutually exclusive with an Excludes1 note, meaning the two conditions cannot occur in the same patient — so exactly one of them is correct for any given encounter.
F32
Depressive episode
Not billable
- Chapter 5
- Mental, Behavioral and Neurodevelopmental disorders
- Section
- F30-F39
Use when the record says
- single episode of agitated depression
- single episode of depressive reaction
- single episode of major depression
- single episode of psychogenic depression
- single episode of reactive depression
- single episode of vital depression
R40.1
Stupor
Billable
- Chapter 18
- Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified
- Section
- R40-R46
Use when the record says
- Catatonic stupor
- Semicoma
Indexed under
- Clouded state
- Semicoma
- Stupor (catatonic)
- Catatonic › stupor
These two codes sit in different chapters of the Tabular List, which is usually the clearest signal that they describe different underlying processes rather than different degrees of the same one.
Excludes1 is not always absolute: where two conditions covered by the note are genuinely unrelated, CMS guidance permits reporting both. Document the reasoning rather than assuming it. More on Excludes1 vs Excludes2 · FY2027