Symptoms and signs involving cognition, perception, emotional state and behavior
ICD-10 Codes (66)
R41R41.0R41.1R41.2R41.3R41.4R41.8R41.81R41.82R41.83R41.84R41.840R41.841R41.842R41.843R41.844R41.85R41.89R41.9R42R43R43.0R43.1R43.2R43.8R43.9R44R44.0R44.1R44.2R44.3R44.8R44.9R45R45.0R45.1R45.2R45.3R45.4R45.5R45.6R45.7R45.8R45.81R45.82R45.83R45.84R45.85R45.850R45.851R45.86R45.87R45.88R45.89R46R46.0R46.1R46.2R46.3R46.4R46.5R46.6R46.7R46.8R46.81R46.89Updates & Changes
FY 2026 Updates
Deleted Codes
No codes deleted in this range for FY 2026
No significant changes for FY 2026
This range maintains stability with current coding practices
Historical Changes
- •FY 2025: Routine maintenance updates with minor terminology clarifications
- •FY 2024: Enhanced specificity requirements for certain code ranges
- •FY 2023: Updated documentation guidelines for improved clarity
Upcoming Changes
- •Proposed updates pending review by Coordination and Maintenance Committee
- •Under consideration: Enhanced digital health integration codes
Implementation Guidance
- •Review all FY 2026 updates for R40-R46 codes before implementation
- •Always verify the most current codes in the ICD-10-CM manual
- •Ensure clinical documentation supports the selected diagnosis codes
- +3 more guidance items...
Range Overview
The ICD-10 code range R40-R46 encompasses symptoms and signs involving cognition, perception, emotional state, and behavior. These codes are used to document various cognitive and behavioral symptoms that are not linked to a specific diagnosis but are significant enough to warrant medical attention. They cover a broad spectrum of conditions, from somnolence and stupor to perceptual disturbances and emotional lability.
Key Usage Points:
- •These codes are used when symptoms are present, but a definitive diagnosis has not been established.
- •They can be used in conjunction with other codes to provide a more comprehensive clinical picture.
- •The codes should reflect the current state of the patient at the time of the encounter.
- •Always code the underlying condition first, if known.
- •Use additional codes to identify any associated underlying conditions.
Coding Guidelines
When to Use:
- ✓When a patient presents with cognitive or behavioral symptoms without a definitive diagnosis.
- ✓When a patient's symptoms are significant enough to warrant medical attention.
- ✓When the patient's symptoms are affecting their daily life or functioning.
- ✓When the symptoms are a significant part of the clinical picture, even if an underlying condition is known.
When NOT to Use:
- ✗When a definitive diagnosis has been established.
- ✗When the symptoms are minor and do not affect the patient's functioning.
- ✗When the symptoms are expected or typical of a diagnosed condition.
- ✗When the symptoms are not a significant part of the clinical picture.
Code Exclusions
Always verify exclusions with the latest version of the ICD-10 manual.
Documentation Requirements
Proper documentation is crucial for accurate coding. It should include a detailed description of the patient's symptoms, their duration, severity, and impact on daily functioning. Any known or suspected underlying conditions should also be documented.
Clinical Information:
- •Detailed description of the patient's symptoms
- •Duration of the symptoms
- •Severity of the symptoms
- •Impact of the symptoms on daily functioning
- •Known or suspected underlying conditions
Supporting Evidence:
- •Clinical notes
- •Lab results
- •Imaging studies
- •Patient's self-reported symptoms
Good Documentation Example:
Patient presents with severe emotional lability, experiencing rapid and extreme changes in mood over the past two weeks. Symptoms are significantly affecting daily functioning.
Poor Documentation Example:
Patient is emotional.
Common Documentation Errors:
- âš Not providing enough detail about the symptoms
- âš Failing to document the impact of the symptoms on daily functioning
- âš Not documenting any known or suspected underlying conditions
- âš Not updating the documentation as the patient's condition changes
Range Statistics
Coding Complexity
The complexity of these codes is medium due to the need to accurately assess the significance of the symptoms and their relation to any known or suspected underlying conditions. Coders also need to stay up-to-date with changes to the coding guidelines.
Key Factors:
- â–¸Determining whether the symptoms are significant enough to warrant coding
- â–¸Determining whether the symptoms are due to a known or suspected underlying condition
- â–¸Determining whether the symptoms are a significant part of the clinical picture
- â–¸Keeping up-to-date with changes to the coding guidelines
Specialty Focus
These codes are commonly used in psychiatry, neurology, and primary care. They can be used to document a wide range of cognitive and behavioral symptoms, making them applicable in many clinical scenarios.
Primary Specialties:
Clinical Scenarios:
- • A patient presents with severe emotional lability without a known cause.
- • A patient with a known neurological disorder presents with new cognitive symptoms.
- • A patient presents with perceptual disturbances without a known cause.
- • A patient presents with cognitive symptoms that are affecting their daily functioning.
Resources & References
There are many resources available to help with coding in the R40-R46 range. These include the official ICD-10 manual, coding training sessions, and online coding forums.
Official Guidelines:
- ICD-10 manual
- World Health Organization (WHO) ICD-10 guidelines
- American Health Information Management Association (AHIMA) coding guidelines
- Centers for Disease Control and Prevention (CDC) ICD-10 guidelines
Clinical References:
- American Psychiatric Association (APA) Diagnostic and Statistical Manual of Mental Disorders (DSM-5)
- National Institute of Mental Health (NIMH) clinical guidelines
- American Academy of Neurology (AAN) clinical guidelines
Educational Materials:
- AHIMA coding training sessions
- Online coding forums
- Coding textbooks and workbooks
Frequently Asked Questions
Can these codes be used in conjunction with other codes?
Yes, these codes can be used in conjunction with other codes to provide a more comprehensive clinical picture. However, always code the underlying condition first, if known.
What is the difference between R40-R46 and F00-F99?
The R40-R46 range is used to code symptoms and signs involving cognition, perception, emotional state, and behavior, while the F00-F99 range is used to code mental and behavioral disorders. The R40-R46 codes should not be used if a definitive diagnosis has been established.