R40.20 — Unspecified coma
Is R40.20 billable?
Yes, but R40.20 is an unspecified code. R40.20 is a valid, billable ICD-10-CM code for encounters from October 1, 2026 through September 30, 2027. However, R40.20 is an unspecified or catch-all code. Payers apply additional scrutiny to unspecified codes and many deny them when the medical record supports a more specific option, so check the documentation before selecting R40.20 — the more specific alternatives are listed below.
R40.20 at a glance
| Code | R40.20 |
|---|---|
| Description | Unspecified coma |
| Billable | Yes |
| Code set | ICD-10-CM FY2027 |
| Valid for encounters | October 1, 2026 – September 30, 2027 |
Which MS-DRGs does R40.20 group to?
R40.20 sits in MDC 01 and helps define the logic of 2 MS-DRGs (version 44, FY2027). Which one a stay actually groups to also depends on procedures and secondary diagnoses.
- 080Nontraumatic Stupor and Coma with MCCmedical
- 081Nontraumatic Stupor and Coma without MCCmedical
As a secondary diagnosis, R40.20 is a major complication or comorbidity (MCC), which can move a stay into a higher-paying DRG.
How is R40.20 listed in the Alphabetic Index?
These are the routes through the Alphabetic Index that lead to R40.20. They show the wording a clinician may have documented, which often differs from the Tabular description.
- Coma
Inclusion terms
Alternative wording in documentation that is classified to R40.20.
- Coma NOS
- Unconsciousness NOS
Excludes1 — never code together — inherited from R40
The conditions below can never be reported together with R40.20 on the same claim. An Excludes1 note means the two conditions cannot occur in the same patient, so reporting both is a coding error.
Code first — inherited from R40.2
The underlying condition below must be sequenced before R40.20. R40.20 describes a manifestation and cannot be the principal or first-listed diagnosis.
Excludes2 — not included here — inherited from Chapter 18
The conditions below are not part of R40.20, but a patient may have both at the same time. When documentation supports it, R40.20 and the excluded code may both be reported.
Excludes2 — not included here — inherited from R40-R46
The conditions below are not part of R40.20, but a patient may have both at the same time. When documentation supports it, R40.20 and the excluded code may both be reported.
- symptoms and signs constituting part of a pattern of mental disorder (F01-F99)
How long has R40.20 existed?
R40.20 has been in ICD-10-CM since at least FY2016, the earliest fiscal year on record here.
Derived from the official order files for FY2016–FY2026. FY2017 and FY2020 publish no order file, so those years are not covered.