R40.221 ICD-10-CM Code: Coma scale, best verbal response, none
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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)
R40.221
Header CodeICD-10-CMOfficial ICD-10-CMCodebook guidanceComa scale, best verbal response, none
Coma scale, best verbal response, none
CMS-HCC V28
00
RAF 0
CMS-HCC V24
00
RAF 0
ACA/HHS
00
RAF 0
ESRD/PACE
00
RAF 0
RXHCC
00
RAF 0
Code Trumping
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Code Book Path
Inclusion Terms
Official- Coma scale verbal score of 1
Excludes 2
OfficialICD-10-CM does not list Excludes 2 notes for R40.221 in this effective period.
Related Child Codes
Includes
OfficialICD-10-CM does not list Includes notes for R40.221 in this effective period.
Excludes 1
OfficialICD-10-CM does not list Excludes 1 notes for R40.221 in this effective period.
Code First
OfficialICD-10-CM does not list Code First sequencing instructions for R40.221 in this effective period.
Use Additional
OfficialICD-10-CM does not list Use Additional Code instructions for R40.221 in this effective period.
Code Also
OfficialICD-10-CM does not list Code Also instructions for R40.221 in this effective period.
Last updated: FY2026 ICD-10-CM Apr update, Apr 1, 2026 through Sep 30, 2026. CMS-HCC V28 is 100% phased in for payment year 2026.
What This Code Means
R40.221 is the ICD-10-CM diagnosis code for coma scale, best verbal response, none. R40.221 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 R40.221 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 R40.221'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 R40.221 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.