2027 ICD-10-CM Diagnosis Code R41.89Other symptoms and signs involving cognitive functions and awareness
ICD-10-CM Codes›R00–R99›R40-R46›R41
- Billable — Valid for Submission
- Not Chronic
ICD-10-CM R41.89
R41.89 is a billable ICD-10-CM diagnosis code for other symptoms and signs involving cognitive functions and awareness. It is valid on HIPAA claims for fiscal year 2027 (October 1, 2026 through September 30, 2027) and groups to MS-DRG 884. As a symptom code, it should not be used as a principal diagnosis once a related definitive diagnosis has been established. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Nervous system signs and symptoms.
Code Identity
ICD-10-CM Code
R41.89
Billable Status
Yes — Valid for Submission
Code Describes
Other symptoms and signs involving cognitive functions and awareness
Short Description
Oth symptoms and signs w cognitive functions and awareness
Code Classification
ChapterR00–R99Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified
This CodeR41.89Other symptoms and signs involving cognitive functions and awareness
Approximate SynonymsGuidance
Alternate terms and clinical phrases that map to this code.
- Able to think clearly
- Abnormal ability to understand
- Abnormal motivation
- Abnormal sexual behavior
- Absence of motivation
- Absences
- Acenesthesia
- Acting out - mental defense mechanism
- Akatamathesia
- Akinetic apraxia
- Akinetic mutism
- Alethia
- Altered thought processes
- Altruism - mental defense mechanism
- Amount of thought - finding
- Anticipation - mental defense mechanism
- Anxious avoidant attachment
- Arbitrary inference
- Autistic thinking
- Bizarre thoughts
- Black and white thinking
- Bradyphrenia
- Catastrophization
- Cerebral alteration
- Cerebral irresponsivity
- Circumstantiality
- Clang associations
- Clarity of thought - finding
- Cognitive impairment caused by alcohol
- Cognitive impairment co-occurrent and due to primary psychotic disorder
- Cognitive impairment due to late-delayed irradiation of brain
- Cognitive impairment due to multiple sclerosis
- Cognitive impairment, coarse facies, heart defects, obesity, pulmonary involvement, short stature, skeletal dysplasia syndrome
- Cognitive perceptual pattern
- Cognitive style - finding
- Conceptual disorganization
- Concrete thinking
- Conversion - mental defense mechanism
- Countertransference
- Creative thought
- Dangerous and harmful thoughts
- Delusional projection - mental defense mechanism
- Denial - mental defense mechanism
- Dependent attachment
- Depressive preoccupation
- Difficulty analyzing information
- Difficulty comprehending concept of danger
- Difficulty in thinking independently
- Difficulty making considered choices
- Difficulty making decisions
- Difficulty making plans
- Difficulty performing logical sequencing
- Difficulty processing information
- Difficulty processing information accurately
- Difficulty reasoning
- Difficulty recognizing consequences of sexual behavior
- Difficulty telling the time
- Difficulty using decision making strategies
- Digit span forwards performance impaired
- Digit span performance - finding
- Digit span reverse performance impaired
- Diminished judgement
- Disinhibited thoughts
- Disorder of brain due to and following radiotherapy
- Disorder of form of thought
- Disorganized attachment
- Disorganized thinking
- Displacement - mental defense mechanism
- Dissociative neurological symptom disorder co-occurrent with cognitive impairment
- Disturbance in content of thought
- Disturbance in intuition
- Disturbance in judgement
- Disturbance in speed of associations
- Disturbance in structure of associations
- Disturbance in thinking
- Disturbance of cognitive learning
- Disturbance of understanding
- Does not recognize numbers
- Does not recognize photographs of self
- Does not recognize self
- Does not recognize self in mirror
- Ego strength finding
- Egomania
- Eroticized transference
- Erotographomania
- Excessively focused attention
- Expansive ideation
- Experience of influence, control, and passivity
- False sense of well-being
- Fantasizing
- Fast flow of thought
- Finding related to ability to find way around a familiar environment
- Finding related to ability to make considered choices
- Finding related to ability to recognize faces
- Finding related to ability to recognize faces by sight
- Finding related to ability to recognize familiar people
- Finding related to ability to recognize objects
- Finding related to ability to recognize objects by sight
- Finding related to ability to recognize objects by touch
- Finding related to ability to recognize odors
- Finding related to ability to recognize other persons
- Finding related to ability to recognize own fingers
- Finding related to ability to recognize parts of own body
- Finding related to ability to recognize self
- Finding related to ability to recognize sounds
- Finding related to ability to recognize surroundings
- Finding related to ability to recognize warning sounds
- Finding related to ability to tell the time
- Finding related to ability to think abstractly
- Finding related to ability to use arithmetic reasoning
- Finding related to ability to use decision making strategies
- Finding related to awareness of rules and boundaries
- Finding related to logical sequencing ability
- Finding related to numeracy level
- Finding related to use of statements
- Finding relating to immediate recall
- Finding relating to rules and boundaries
- Flight of ideas
- Funny turn
- GDS level 2 - very mild cognitive decline
- GDS level 3 - mild cognitive decline
- GDS level 4 - moderate cognitive decline
- GDS level 5 - moderately severe cognitive decline
- GDS level 6 - severe cognitive decline
- GDS level 7 - very severe cognitive decline
- Genetic syndromic childhood obesity
- Global deterioration scale finding for assessment of primary degenerative dementia
- Glossolalia
- Harmful thoughts
- Has imaginary friend
- Hemispatial neglect
- High ego strength
- Human immunodeficiency virus infection with cognitive impairment
- Humor - mental defense mechanism
- Hypotonic-hyporesponsive episode
- Idealization - mental defense mechanism
- Idealizing transference
- Identification - mental defense mechanism
- Identification with the aggressor - mental defense mechanism
- Illogical thinking
- Immature behavior
- Impaired ability to learn new material
- Impaired cognition
- Impaired environmental interpretation syndrome
- Impaired insight
- Impaired reality testing
- Impairment of mental alertness
- Impairment of psychological status
- Incoherent thinking
- Incomplete clearmindedness
- Increased thinking
- Independence of thought - finding
- Ineffective denial
- Infantile-onset mesial temporal lobe epilepsy with severe cognitive regression
- Information conversion problem
- Insecure attachment
- Insecure avoidant attachment
- Intellectual faculties - finding
- Intellectualization - mental defense mechanism
- Intent of deliberate self harm with detailed plans
- Introjection - mental defense mechanism
- Intrusive memories
- Intrusive thoughts
- Irrational thoughts
- Irrelevant answer
- Isolated artistic skills
- Isolated calendar skills
- Isolated musical skills
- Isolated number skills
- Isolated skills associated with general impairment
- Isolated visuospatial skills
- Isolation - mental defense mechanism
- Judgement - finding
- Knight's move in thought
- Lack of awareness
- Lack of common sense about danger
- Lack of insight
- Lack of intuition
- Lack of judgement
- Lack of self awareness
- Lack of thinking ability
- Level of psychoticism - finding
- Limited ability to think abstractly
- Limited reasoning ability
- Loosening of associations
- Loss of direction of thought
- Loss of judgement
- Loud thoughts
- Low ego strength
- Low level of psychoticism
- Magical thinking
- Memory recall finding
- Mental condensation
- Mentally vague
- Mesial temporal lobe epilepsy
- Minimal cognitive impairment
- Minimally conscious state
- Minimally conscious state minus
- Minimally conscious state plus
- Mistakes people's identity
- Mixed avoidant attachment
- Moderate ego strength
- Moderate level of psychoticism
- Monomania
- Morbid thoughts
- Negative automatic thoughts
- Negative transference
- Noesis
- Non sequiturs
- Non-awareness of common dangers
- Noncompliance with medication regimen due to cognitive impairment
- Nonpersistence
- Nonspecific paroxysmal spell
- Non-verbally indicates understanding
- Not aware of danger from deep water
- Not aware of danger from falling from heights
- Not aware of danger from fire
- Not aware of danger from hot lamp
- Not aware of danger from hot objects
- Not aware of danger from hot stoves
- Not aware of danger from hot water
- Not aware of danger from sharp objects
- Not aware of danger from strangers
- Not aware of danger from traffic
- Not wanting to think
- Not wanting to think about something
- Obscene thoughts
- Omnipotence - mental defense mechanism
- Organic disorder of body schema
- Overgeneralization
- Overvalued idea
- Palinacousia
- Palinesthesia
- Partial insight
- Passive aggression - mental defense mechanism
- Persistent thoughts
- Phobic avoidance - mental defense mechanism
- Planning extravagant projects
- Planning unworkable projects
- Plans for deliberate self harm without intent
- Pleasant fantasy
- Poor grasp of abstract concepts
- Pornographic fantasy
- Positive symptoms co-occurrent and due to primary psychotic disorder
- Positive transference
- Poverty of thought
- Prelogical thinking
- Preoccupation
- Preoccupation of thought
- Preoccupation with appearance
- Preoccupation with body shape
- Preoccupation with body size
- Preoccupation with compensation
- Preoccupation with death
- Preoccupation with disaster
- Preoccupation with litigation
- Preoccupation with ruin
- Preoccupation with specific bodily feature
- Preoccupied with emotional problems
- Pressure of thought
- Primitive idealization - mental defense mechanism
- Projection - mental defense mechanism
- Psychodynamic complexes
- Psychotic denial - mental defense mechanism
- Puzzled
- Racing thoughts
- Rationalization - mental defense mechanism
- Reaction-formation - mental defense mechanism
- Reappearance of old thoughts
- Reduced distortion in thinking
- Reduced level of decisional conflict
- Referential thoughts
- Regression - mental defense mechanism
- Regression through acting in
- Regression through acting out
- Regression through actualizing
- Regression through enacting
- Regression through recapitulation
- Reliving traumatic memories
- Repetitive complaining
- Repetitive questioning
- Repressing painful memories
- Repressing thoughts
- Repression - mental defense mechanism
- Repression through denial
- Repression through forgetting
- Reversal - mental defense mechanism
- Rigidity of thinking
- Rumination - thoughts
- Secure attachment
- Selective abstraction
- Self-object transference
- Sense of impending doom
- Sharpened thinking
- Slow flow of thought
- Sluggish thought
- Speed of thought - finding
- Splitting - mental defense mechanism
- Sublimation - mental defense mechanism
- Suggestible
- Suppression - mental defense mechanism
- Tangential thinking
- Thought alienation
- Thought block
- Thought insertion
- Thought withdrawal
- Thoughts of deliberate self harm
- Thoughts of self harm
- Transference
- Turning against the self - mental defense mechanism
- Type of memories - finding
- Unable to analyze information
- Unable to comprehend concept of danger
- Unable to find way around a familiar environment
- Unable to make considered choices
- Unable to make decisions about medical treatment due to impaired mental capacity
- Unable to perform logical sequencing
- Unable to plan
- Unable to process information
- Unable to process information accurately
- Unable to process information at normal speed
- Unable to reason
- Unable to recognize faces
- Unable to recognize faces by sight
- Unable to recognize familiar people
- Unable to recognize objects
- Unable to recognize objects by sight
- Unable to recognize objects by touch
- Unable to recognize odors
- Unable to recognize own fingers
- Unable to recognize parts of own body
- Unable to recognize sounds
- Unable to recognize surroundings
- Unable to recognize warning sounds
- Unable to set personal goals
- Unable to tell the time
- Unable to think clearly
- Unable to use statements
- Unable to use arithmetic reasoning
- Unable to use decision making strategies
- Unaware of rules and boundaries
- Unconscious fantasy
- Undoing - mental defense mechanism
- Unio mystica
- Unpleasant memories
- Unrealistic planning
- Unresponsive
- Unusually creative thinking
- Use of imagination - finding
- Verbal repetition
Instructional NotesGuidance
Instructions from the official ICD-10-CM Tabular List that apply to R41.89: its own notes plus those printed at R41, block R40-R46, and Chapter 18. A note printed at a category, block or chapter applies to every code under it.
Excludes1
Not coded here: the excluded code is never reported together with this one, unless the two conditions are unrelated.
Excludes2
Not included here: the excluded condition is not part of this code, but a patient may have both, so both codes may be reported.
From Block R40-R46 Symptoms and signs involving cognition, perception, emotional state and behavior applies to 157 codes
From Chapter 18 (R00-R99) Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified applies to 774 codes
Notes
General instructions on how these codes are used.
From Chapter 18 (R00-R99) Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified applies to 774 codes
- This chapter includes symptoms, signs, abnormal results of clinical or other investigative procedures, and ill-defined conditions regarding which no diagnosis classifiable elsewhere is recorded.
- Signs and symptoms that point rather definitely to a given diagnosis have been assigned to a category in other chapters of the classification. In general, categories in this chapter include the less well-defined conditions and symptoms that, without the necessary study of the case to establish a final diagnosis, point perhaps equally to two or more diseases or to two or more systems of the body. Practically all categories in the chapter could be designated 'not otherwise specified', 'unknown etiology' or 'transient'. The Alphabetical Index should be consulted to determine which symptoms and signs are to be allocated here and which to other chapters. The residual subcategories, numbered .8, are generally provided for other relevant symptoms that cannot be allocated elsewhere in the classification.
- The conditions and signs or symptoms included in categories R00-R94 consist of:
- (a) cases for which no more specific diagnosis can be made even after all the facts bearing on the case have been investigated;
- (b) signs or symptoms existing at the time of initial encounter that proved to be transient and whose causes could not be determined;
- (c) provisional diagnosis in a patient who failed to return for further investigation or care;
- (d) cases referred elsewhere for investigation or treatment before the diagnosis was made;
- (e) cases in which a more precise diagnosis was not available for any other reason;
- (f) certain symptoms, for which supplementary information is provided, that represent important problems in medical care in their own right.
Source: CMS ICD-10-CM Tabular List. How to read instructional notes.
Index to Diseases and InjuriesGuidance
Alphabetical index entries that point to this code.
Akinetic mutism R41.89
Change (s) (in) (of) See Also: Removal;
cognitive (mild) (organic) R41.89
Deficit See Also: Deficiency;
cognitive NEC R41.89
Disorder (of) See Also: Disease;
persisting R41.89
Trance R41.89
Clinical ClassificationClinical
AHRQ’s CCSR groups this code into broader clinical categories.
CCSR SYM010
Nervous system signs and symptoms
Default principal diagnosis: inpatient Yes · outpatient Yes
Clinical InformationClinical
Akinetic Mutism
a syndrome characterized by a silent and inert state without voluntary motor activity despite preserved sensorimotor pathways and vigilance. bilateral frontal lobe dysfunction involving the anterior cingulate gyrus and related brain injuries are associated with this condition. this may result in impaired abilities to communicate and initiate motor activities. (from adams et al., principles of neurology, 6th ed, p348; fortschr neurol psychiatr 1995 feb;63(2):59-67)
Patient EducationClinical
Mental Disorders
Mental disorders (or mental illnesses) are conditions that affect your thinking, feeling, mood, and behavior. They may happen over a short period of time or come and go. Some can be chronic (long-lasting). They can affect your ability to relate to others and function each day..
The full article covers:
- What are mental disorders?
- What are some types of mental disorders?
- What causes mental disorders?
- Who is at risk for mental disorders?
- How are mental disorders diagnosed?
- What are the treatments for mental disorders?
Read the full article at MedlinePlus
Courtesy of MedlinePlus, a service of the U.S. National Library of Medicine.
Convert R41.89 to ICD-9-CMHistory
The closest ICD-9-CM equivalents under the General Equivalence Mappings.
Code HistoryHistory
FY 2016AddedAdded to the ICD-10-CM code setEffective October 1, 2015, the first year of ICD-10-CM.
FY 2017–2026No changes
FY 2027CurrentCurrent code set, no changesEffective October 1, 2026 through September 30, 2027.
Questions About R41.89Overview
What is the ICD-10 code for other symptoms and signs involving cognitive functions and awareness?
The ICD-10-CM code for other symptoms and signs involving cognitive functions and awareness is R41.89 (sometimes written as R4189). It is billable on HIPAA-covered claims from October 1, 2026 through September 30, 2027.
Is R41.89 a billable code?
Yes. This is a billable ICD-10-CM code, specific enough to report other symptoms and signs involving cognitive functions and awareness on HIPAA-covered claims from October 1, 2026 through September 30, 2027.
What MS-DRG does R41.89 group to?
When other symptoms and signs involving cognitive functions and awareness is the principal diagnosis on an inpatient stay, it groups to MS-DRG 884 (organic Disturbances and Intellectual Disability), which carries a relative weight of 1.5998. Higher weights mean higher Medicare reimbursement.
Can R41.89 be a principal diagnosis?
Use it with care. This is a symptom code, so once a definitive diagnosis explaining the other symptoms and signs involving cognitive functions and awareness is established, that condition takes the principal position instead.
Can R41.89 be reported with a code from F44?
Not as a rule. The Excludes1 note at R41, which applies to R41.89, lists "dissociative [conversion] disorders (F44.-)". An Excludes1 note means the excluded code is never reported together with this one; the only exception is when the two conditions are unrelated to each other (Official Guidelines, Section I.A.12.a).
