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v1.0.0
ICD-10 Guide
ICD-10 CodesR40.1

R40.1

Billable

Stupor

BILLABLE STATUSYes
IMPLEMENTATION DATEOctober 1, 2015
LAST UPDATED09/11/2025

Code Description

ICD-10 R40.1 is a billable code used to indicate a diagnosis of stupor.

Key Diagnostic Point:

Stupor is a state of near-unconsciousness or insensibility characterized by a lack of response to stimuli, reduced awareness of the environment, and diminished motor activity. Patients in stupor may appear unresponsive and may not react to verbal commands or physical stimuli. This condition can arise from various underlying causes, including metabolic disturbances, neurological disorders, intoxication, or severe infections. Clinical evaluation often reveals a decreased level of consciousness, and patients may exhibit abnormal vital signs or neurological findings. Laboratory tests may show electrolyte imbalances, toxicology results, or signs of infection. Prompt identification of the underlying cause is crucial for effective management and recovery. Stupor is often a medical emergency, necessitating immediate assessment and intervention to prevent further deterioration.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variety of underlying causes requiring differential diagnosis
  • Potential overlap with other altered mental status codes
  • Need for comprehensive documentation of clinical findings
  • Variability in presentation based on etiology

Audit Risk Factors

  • Inadequate documentation of the patient's level of consciousness
  • Failure to specify the underlying cause of stupor
  • Misuse of stupor code when a more specific diagnosis exists
  • Lack of supporting lab results or clinical findings

Specialty Focus

Medical Specialties

Internal Medicine

Documentation Requirements

Detailed history and physical examination findings, including mental status assessment and any relevant lab results.

Common Clinical Scenarios

Patients presenting with altered mental status due to metabolic derangements, infections, or drug overdoses.

Billing Considerations

Ensure documentation reflects the timeline of symptoms and any interventions performed.

Emergency Medicine

Documentation Requirements

Immediate assessment findings, including vital signs, Glasgow Coma Scale score, and any interventions initiated.

Common Clinical Scenarios

Acute presentations of stupor due to trauma, overdose, or severe infection.

Billing Considerations

Document all emergency interventions and the patient's response to treatment.

Coding Guidelines

Inclusion Criteria

Use R40.1 When
  • Follow official ICD
  • CM coding guidelines, ensuring that the stupor is not a symptom of a more specific diagnosis
  • Document the clinical context and any relevant findings that support the use of R40

Exclusion Criteria

Do NOT use R40.1 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

99285CPT Code

Emergency department visit, high severity

Clinical Scenario

Used when a patient presents with stupor requiring immediate evaluation and management.

Documentation Requirements

Document the patient's presenting symptoms, level of consciousness, and any interventions performed.

Specialty Considerations

Emergency medicine providers should ensure thorough documentation of the patient's condition and response to treatment.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of conditions like stupor, improving the granularity of data for clinical and billing purposes. This specificity aids in better understanding patient populations and outcomes.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of conditions like stupor, improving the granularity of data for clinical and billing purposes. This specificity aids in better understanding patient populations and outcomes.

Reimbursement & Billing Impact

billing purposes. This specificity aids in better understanding patient populations and outcomes.

Resources

Clinical References

  • •
    ICD-10-CM Official Guidelines for Coding and Reporting

Coding & Billing References

  • •
    ICD-10-CM Official Guidelines for Coding and Reporting

Frequently Asked Questions

What is the difference between stupor and coma?

Stupor is a state of reduced responsiveness where the patient may respond to stimuli but is generally unresponsive, while coma is a deeper state of unresponsiveness where the patient does not respond to any stimuli.