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R40 ICD-10-CM Code: Somnolence, stupor and coma

R40 is not a CMS-HCC payment code. MEAT criteria · RAF calculator · HCC Buddy coding tools

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FY 2026 Apr update / Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R99) / Symptoms and signs involving cognition, perception, emotional state and behavior (R40-R46)

R40

Header CodeICD-10-CMOfficial ICD-10-CMCodebook guidance

Somnolence, stupor and coma

Somnolence, stupor and coma

CMS-HCC V28

N/A

Not mapped

CMS-HCC V24

N/A

Not mapped

ACA/HHS

N/A

Not mapped

ESRD/PACE

N/A

Not mapped

RXHCC

N/A

Not mapped

Code Book Path

Official
R4Symptoms and signs involving cognition, perception, emotional state and behavior (R40-R46)
R40Somnolence, stupor and coma

Inclusion Terms

Official

ICD-10-CM does not list inclusion terms for R40 in this effective period.

Excludes 2

Official

ICD-10-CM does not list Excludes 2 notes for R40 in this effective period.

Related Child Codes

Official
R40.0Somnolence
R40.1Stupor
R40.2Coma
R40.3Persistent vegetative state
R40.4Transient alteration of awareness

Includes

Official

ICD-10-CM does not list Includes notes for R40 in this effective period.

Excludes 1

Official
  • 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

Official

ICD-10-CM does not list Code First sequencing instructions for R40 in this effective period.

Use Additional

Official

ICD-10-CM does not list Use Additional Code instructions for R40 in this effective period.

Code Also

Official

ICD-10-CM does not list Code Also instructions for R40 in this effective period.

Current with CMS: FY2026 ICD-10-CM Apr 1 update (effective Apr 1 – Sep 30, 2026) · CMS-HCC V28, 100% phased in for payment year 2026. FY2027 code set already staged for October 1, 2026. How HCC Buddy stays current →

Code
R40
Description
Somnolence, stupor and coma
HCC (V28)
No CMS-HCC V28 mapping
RAF
Billable
No
Payment year
2026

Coder workflow notes

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What This Code Means

R40 is the ICD-10-CM diagnosis code for somnolence, stupor and coma. R40 sits in the ICD-10-CM chapter for symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (r00-r99), within the section covering symptoms and signs involving cognition, perception, emotional state and behavior (r40-r46).

Header codes like R40 cannot be reported on claims directly, they organize child codes that share clinical context but the actual diagnosis must be coded to the highest level of specificity supported by the documentation. Coders should look at R40's child codes and select the one that matches the patient's documented presentation, since payers reject header codes submitted as the primary diagnosis. For risk adjustment workflows, header codes never contribute to a Medicare Advantage member's RAF score on their own; only billable child codes that happen to map to a payment HCC affect risk-adjusted plan payments.

HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for R40 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Excludes 1, Do NOT code together

  • 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)

Child Codes

Code Hierarchy

R40Somnolence, stupor and coma
R40Somnolence, stupor and coma

Work R40 in HCC Buddy

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