R40 - Somnolence, stupor and coma
|Short Description:||Somnolence, stupor and coma|
|Long Description:||Somnolence, stupor and coma|
|Status:||Not Valid for Submission|
R40 is a non-specific and non-billable ICD-10 code code, consider using a code with a higher level of specificity for a diagnosis of somnolence, stupor and coma. The code is not specific and is NOT valid for the year 2023 for the submission of HIPAA-covered transactions. Category or Header define the heading of a category of codes that may be further subdivided by the use of 4th, 5th, 6th or 7th characters.
According to ICD-10-CM guidelines this code should not to be used as a principal diagnosis code when a related definitive diagnosis has been established.
Specific Coding for Somnolence, stupor and coma
Non-specific codes like R40 require more digits to indicate the appropriate level of specificity. Consider using any of the following ICD-10 codes with a higher level of specificity when coding for somnolence, stupor and coma:
- BILLABLE CODE - Use R40.0 for Somnolence
- BILLABLE CODE - Use R40.1 for Stupor
- NON-BILLABLE CODE - R40.2 for Coma
- BILLABLE CODE - Use R40.20 for Unspecified coma
- NON-BILLABLE CODE - R40.21 for Coma scale, eyes open
- NON-BILLABLE CODE - R40.22 for Coma scale, best verbal response
- NON-BILLABLE CODE - R40.23 for Coma scale, best motor response
- NON-BILLABLE CODE - R40.24 for Glasgow coma scale, total score
- BILLABLE CODE - Use R40.3 for Persistent vegetative state
- BILLABLE CODE - Use R40.4 for Transient alteration of awareness
Tabular List of Diseases and Injuries
The Tabular List of Diseases and Injuries is a list of ICD-10 codes, organized "head to toe" into chapters and sections with coding notes and guidance for inclusions, exclusions, descriptions and more. The following references are applicable to this diagnosis code:
Type 1 ExcludesType 1 Excludes
A type 1 excludes note is a pure excludes note. It means "NOT CODED HERE!" An Excludes1 note indicates that the code excluded should never be used at the same time as the code above the Excludes1 note. An Excludes1 is used when two conditions cannot occur together, such as a congenital form versus an acquired form of the same condition.
A coma is a deep state of unconsciousness. An individual in a coma is alive but unable to move or respond to his or her environment. Coma may occur as a complication of an underlying illness, or as a result of injuries, such as brain injury.
A coma rarely lasts more than 2 to 4 weeks. The outcome for coma depends on the cause, severity, and site of the damage. People may come out of a coma with physical, intellectual, and psychological problems. Some people may remain in a coma for years or even decades. For those people, the most common cause of death is infection, such as pneumonia.
NIH: National Institute of Neurological Disorders and Stroke
[Learn More in MedlinePlus]
What is sleep?
Sleep is a complex biological process. While you are sleeping, you are unconscious, but your brain and body functions are still active. They are doing a number of important jobs that help you stay healthy and function at your best. So when you don't get enough quality sleep, it does more than just make you feel tired. It can affect your physical and mental health, thinking, and daily functioning.
What are sleep disorders?
Sleep disorders are conditions that disturb your normal sleep patterns. There are more than 80 different sleep disorders. Some major types include:
- Insomnia - being unable to fall asleep and stay asleep. This is the most common sleep disorder.
- Sleep apnea - a breathing disorder in which you stop breathing for 10 seconds or more during sleep
- Restless leg syndrome (RLS) - a tingling or prickly sensation in your legs, along with a powerful urge to move them
- Hypersomnia - being unable to stay awake during the day. This includes narcolepsy, which causes extreme daytime sleepiness.
- Circadian rhythm disorders - problems with the sleep-wake cycle. They make you unable to sleep and wake at the right times.
- Parasomnia - acting in unusual ways while falling asleep, sleeping, or waking from sleep, such as walking, talking, or eating
Some people who feel tired during the day have a true sleep disorder. But for others, the real problem is not allowing enough time for sleep. It's important to get enough sleep every night. The amount of sleep you need depends on several factors, including your age, lifestyle, health, and whether you have been getting enough sleep recently. Most adults need about 7-8 hours each night.
What causes sleep disorders?
There are different causes for different sleep disorders, including:
- Other conditions, such as heart disease, lung disease, nerve disorders, and pain
- Mental illnesses, including depression and anxiety
Sometimes the cause is unknown.
There are also some factors that can contribute to sleep problems, including:
- Caffeine and alcohol
- An irregular schedule, such as working the night shift
- Aging. As people age, they often get less sleep or spend less time in the deep, restful stage of sleep. They are also more easily awakened.
What are the symptoms of sleep disorders?
The symptoms of sleep disorders depend on the specific disorder. Some signs that you may have a sleep disorder include that:
- You regularly take more than 30 minutes each night to fall asleep
- You regularly wake up several times each night and then have trouble falling back to sleep, or you wake up too early in the morning
- You often feel sleepy during the day, take frequent naps, or fall asleep at the wrong times during the day
- Your bed partner says that when you sleep, you snore loudly, snort, gasp, make choking sounds, or stop breathing for short periods
- You have creeping, tingling, or crawling feelings in your legs or arms that are relieved by moving or massaging them, especially in the evening and when trying to fall asleep
- Your bed partner notices that your legs or arms jerk often during sleep
- You have vivid, dreamlike experiences while falling asleep or dozing
- You have episodes of sudden muscle weakness when you are angry or fearful, or when you laugh
- You feel as though you cannot move when you first wake up
How are sleep disorders diagnosed?
To make a diagnosis, your health care provider will use your medical history, your sleep history, and a physical exam. You may also have a sleep study (polysomnogram). The most common types of sleep studies monitor and record data about your body during a full night of sleep. The data includes:
- Brain wave changes
- Eye movements
- Breathing rate
- Blood pressure
- Heart rate and electrical activity of the heart and other muscles
Other types of sleep studies may check how quickly you fall asleep during daytime naps or whether you are able to stay awake and alert during the day.
What are the treatments for sleep disorders?
Treatments for sleep disorders depend on which disorder you have. They may include:
- Good sleep habits and other lifestyle changes, such as a healthy diet and exercise
- Cognitive behavioral therapy or relaxation techniques to reduce anxiety about getting enough sleep
- CPAP (continuous positive airway pressure) machine for sleep apnea
- Bright light therapy (in the morning)
- Medicines, including sleeping pills. Usually, providers recommend that you use sleeping pills for a short period of time.
- Natural products, such as melatonin. These products may help some people but are generally for short-term use. Make sure to check with your health care provider before you take any of them.
[Learn More in MedlinePlus]
- FY 2023 - No Change, effective from 10/1/2022 through 9/30/2023
- FY 2022 - No Change, effective from 10/1/2021 through 9/30/2022
- FY 2021 - No Change, effective from 10/1/2020 through 9/30/2021
- FY 2020 - No Change, effective from 10/1/2019 through 9/30/2020
- FY 2019 - No Change, effective from 10/1/2018 through 9/30/2019
- FY 2018 - No Change, effective from 10/1/2017 through 9/30/2018
- FY 2017 - No Change, effective from 10/1/2016 through 9/30/2017
- FY 2016 - New Code, effective from 10/1/2015 through 9/30/2016 (First year ICD-10-CM implemented into the HIPAA code set)