R46.4
BillableSlowness and poor responsiveness
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is R46.4 an HCC code?
No. R46.4 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
R46.4 is the ICD-10-CM diagnosis code for slowness and poor responsiveness. Observable slowness in movement, speech, or response to stimuli, along with reduced responsiveness to questions or environmental cues. R46.4 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).
R46.4 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 specific observations such as slow speech, delayed responses, or psychomotor retardation.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for R46.4 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Document specific observations such as slow speech, delayed responses, or psychomotor retardation
- •Consider whether slowness is due to depression, medication effects, neurological conditions, or other causes
Excludes 1 — Do NOT code together
- stupor (R40.1)