R44.1 ICD-10-CM Code: Visual hallucinations
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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)
R44.1
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidanceVisual hallucinations
A person experiences seeing things that are not actually present, such as images, shapes, or figures that only they can perceive.
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
OfficialICD-10-CM does not list inclusion terms for R44.1 in this effective period.
Excludes 2
Official- disturbances of skin sensation (R20.-)
Related Child Codes
Includes
OfficialICD-10-CM does not list Includes notes for R44.1 in this effective period.
Excludes 1
Official- alcoholic hallucinations (F10.151, F10.251, F10.951)
- hallucinations in drug psychosis (F11-F19 with fifth to sixth characters 51)
- hallucinations in mood disorders with psychotic symptoms (F30.2, F31.5, F32.3, F33.3)
- hallucinations in schizophrenia, schizotypal and delusional disorders (F20-F29)
Code First
OfficialICD-10-CM does not list Code First sequencing instructions for R44.1 in this effective period.
Use Additional
OfficialICD-10-CM does not list Use Additional Code instructions for R44.1 in this effective period.
Code Also
OfficialICD-10-CM does not list Code Also instructions for R44.1 in this effective period.
Buddy Documentation Tip
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.
Is R44.1 an HCC code?
No. R44.1 is a billable ICD-10-CM code but does not map to any HCC category in V28, V24, ESRD, or RxHCC.
This code does not map to an HCC category in any model (V28, V24, ESRD, RxHCC).
What This Code Means
R44.1 is the ICD-10-CM diagnosis code for visual hallucinations. A person experiences seeing things that are not actually present, such as images, shapes, or figures that only they can perceive. R44.1 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).
R44.1 is a billable ICD-10-CM code but does not map to a payment HCC under the CMS-HCC V28, V24, ESRD, or RxHCC risk adjustment models. It can be reported on Medicare Advantage encounter data submissions but it does not contribute to a beneficiary's RAF score and therefore does not affect risk-adjusted payments to the plan.
Document whether hallucinations are related to a specific condition (psychiatric, neurological, or substance-induced) for more specific coding if applicable.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for R44.1 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Document whether hallucinations are related to a specific condition (psychiatric, neurological, or substance-induced) for more specific coding if applicable
- •Distinguish from illusions (misinterpretation of real stimuli) which would be coded differently