ICDcodes.org
FY2027

R40.2214Coma scale, best verbal response, none, 24 hours or more after hospital admission

BillableMCC

Is R40.2214 billable?

Yes — R40.2214 is billable for FY2027. R40.2214 is a valid, billable ICD-10-CM code at the highest level of specificity in its branch. R40.2214 may be submitted for encounters from October 1, 2026 through September 30, 2027.

R40.2214 at a glance

CodeR40.2214
DescriptionComa scale, best verbal response, none, 24 hours or more after hospital admission
BillableYes
Code setICD-10-CM FY2027
Valid for encountersOctober 1, 2026 – September 30, 2027
7th character "4"24 hours or more after hospital admission

What does the 7th character "4" mean in R40.2214?

In R40.2214, the 7th character 4 means 24 hours or more after hospital admission. The 7th character is required for R40.2214 to be a valid, complete code.

Same condition, different episode of care — switch the 7th character:

What Medicare edits apply to R40.2214?

The Medicare Code Editor screens inpatient claims before they are grouped. These edits name R40.2214 directly.

Cannot be a principal diagnosis — MCE edit 9

CMS will reject this code as the principal diagnosis on an inpatient claim. It describes something other than the condition chiefly responsible for the admission.

Which MS-DRGs does R40.2214 group to?

R40.2214 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, R40.2214 is a major complication or comorbidity (MCC), which can move a stay into a higher-paying DRG.

How is R40.2214 listed in the Alphabetic Index?

The Alphabetic Index lists these routes under R40.221, the nearest indexed parent of R40.2214. Use them to find the family, then select the specific code.

  • Comawithverbal response
  • Comawithverbal responsescore of1

Inclusion terms

Alternative wording in documentation that is classified to R40.2214.

  • Coma scale verbal score of 1

Excludes1 — never code together — inherited from R40

The conditions below can never be reported together with R40.2214 on the same claim. An Excludes1 note means the two conditions cannot occur in the same patient, so reporting both is a coding error.

  • neonatal coma (P91.5)
  • somnolence, stupor and coma in diabetes (E08-E13)
  • somnolence, stupor and coma in hepatic failure (K72.-)
  • somnolence, stupor and coma in hypoglycemia (nondiabetic) (E15)

Code first — inherited from R40.2

The underlying condition below must be sequenced before R40.2214. R40.2214 describes a manifestation and cannot be the principal or first-listed diagnosis.

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

Excludes2 — not included here — inherited from Chapter 18

The conditions below are not part of R40.2214, but a patient may have both at the same time. When documentation supports it, R40.2214 and the excluded code may both be reported.

  • abnormal findings on antenatal screening of mother (O28.-)
  • certain conditions originating in the perinatal period (P04-P96)
  • signs and symptoms classified in the body system chapters
  • signs and symptoms of breast (N63, N64.5)

Excludes2 — not included here — inherited from R40-R46

The conditions below are not part of R40.2214, but a patient may have both at the same time. When documentation supports it, R40.2214 and the excluded code may both be reported.

  • symptoms and signs constituting part of a pattern of mental disorder (F01-F99)

How long has R40.2214 existed?

R40.2214 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.