2026 ICD-10-CM Diagnosis Code R45.4Irritability and anger

ICD-10-CM Codes›R00–R99›R40-R46›R45

ICD-10-CM R45.4
CMSSource: CMS FY 2026 ICD-10-CM dataset · Effective Oct 1, 2025 – Sep 30, 2026

R45.4 is a billable ICD-10-CM diagnosis code for irritability and anger. It is valid on HIPAA claims for fiscal year 2026 (October 1, 2025 through September 30, 2026). 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 Symptoms of mental and substance use conditions.

Code Identity

ICD-10-CM Code
R45.4
Billable Status
Yes — Valid for Submission
Code Describes
Irritability and anger
Short Description
Irritability and anger
Same as the full description in the CMS dataset.
Parent Code
R45
Symptoms and signs involving emotional state

Code Classification

ChapterR00–R99Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified
SectionR40-R46Symptoms and signs involving cognition, perception, emotional state and behavior
CategoryR45Symptoms and signs involving emotional state
This CodeR45.4Irritability and anger

Approximate SynonymsGuidance

Alternate terms and clinical phrases that map to this code.

  • Able to control anger
  • Able to control emotions
  • Anger reaction
  • Anger stage of grief
  • Breath holding with temper
  • Difficulty controlling anger
  • Difficulty controlling emotions
  • Feeling aggressive
  • Feeling angry
  • Feeling irritable
  • Finding related to ability to control anger
  • Finding related to ability to control emotions
  • Fussy toddler
  • Grieving process stage - finding
  • Hyperirritability
  • Irritability and anger
  • Irritability postvaccinal
  • Oppositional defiant disorder
  • Oppositional defiant disorder co-occurrent with chronic irritability-anger
  • Oppositional defiant disorder co-occurrent with chronic irritability-anger with normal prosocial emotions
  • Outbursts of anger
  • Temper problem
  • Unable to control anger

Index to Diseases and InjuriesGuidance

Alphabetical index entries that point to this code.

External Cause of Injuries IndexGuidance

References for this code in the External Cause of Injuries Index.

    • Anger
    • Irritable, irritability

Clinical ClassificationClinical

AHRQ’s CCSR groups this code into broader clinical categories.

CCSR SYM008
Symptoms of mental and substance use conditions
Default principal diagnosis: inpatient Yes · outpatient Yes

Clinical InformationClinical

  • Oppositional Defiant Disorder

    a repetitive and persistent pattern of behavior that develops in childhood and is characterized as recurrent disobedient, overall negative or agitated mood, a quarrelsome attitude or being vengeful toward authority figures. unlike in conduct disorder defiant behaviors in oppositional defiant disorders typically do not involve aggression, destruction, theft, or deceit. oppositional defiant disorder, conduct disorder and attention deficit and hyperactivity disorder sometimes co-occur.

  • Oppositional Defiant Disorder

    a behavior disorder characterized by a persistent pattern of defiant, disobedient, and hostile behavior towards authority figures, manifested by a frequent loss of temper, arguing, becoming angry or vindictive, or other negativistic behaviors.

Convert R45.4 to ICD-9-CMHistory

The closest ICD-9-CM equivalents under the General Equivalence Mappings.

ICD-9-CM
799.22 Irritability
Approximate The match is approximate rather than exact.

Code HistoryHistory

FY 2016AddedAdded to the ICD-10-CM code setEffective October 1, 2015, the first year of ICD-10-CM.
FY 2017–2025No changes
FY 2026CurrentCurrent code set, no changesEffective October 1, 2025 through September 30, 2026.

Questions About R45.4Overview

Is R45.4 (Symptoms and signs involving emotional state) a billable code?

Yes. This is a billable ICD-10-CM code, specific enough to report irritability and anger on HIPAA-covered claims from October 1, 2025 through September 30, 2026.

Can R45.4 be a principal diagnosis?

Use it with care. This is a symptom code, so once a definitive diagnosis explaining the irritability and anger is established, that condition takes the principal position instead.

What is the ICD-9 equivalent of R45.4?

Under the General Equivalence Mappings, irritability and anger converts to ICD-9-CM 799.22 (irritability). The mapping is approximate, so confirm the match fits the documentation.

Footnotes

[1] Not chronic - A diagnosis code that does not fit the criteria for chronic condition (duration, ongoing medical treatment, and limitations) is considered not chronic. Some codes designated as not chronic are acute conditions. Other diagnosis codes that indicate a possible chronic condition, but for which the duration of the illness is not specified in the code description (i.e., we do not know the condition has lasted 12 months or longer) also are considered not chronic.