2026 ICD-10-CM Diagnosis Code R46.81Obsessive-compulsive behavior

ICD-10-CM CodesR00–R99R40-R46R46

ICD-10-CM R46.81
CMSSource: CMS FY 2026 ICD-10-CM dataset · Effective Oct 1, 2025 – Sep 30, 2026

R46.81 is a billable ICD-10-CM diagnosis code for obsessive-compulsive behavior. It is valid on HIPAA claims for fiscal year 2026 (October 1, 2025 through September 30, 2026). The code is not accepted as a principal diagnosis by the Medicare Code Editor. 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
R46.81
Billable Status
Yes — Valid for Submission
Code Describes
Obsessive-compulsive behavior
Short Description
Obsessive-compulsive behavior
Same as the full description in the CMS dataset.
Parent Code
Other symptoms and signs involving appearance and behavior

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
CategoryR46Symptoms and signs involving appearance and behavior
This CodeR46.81Obsessive-compulsive behavior

Code EditsBilling

Medicare Code Editor checks that affect claim validity for R46.81.

There are selected codes that describe a circumstance which influences an individual's health status but not a current illness or injury, or codes that are not specific manifestations but may be due to an underlying cause. These codes are considered unacceptable as a principal diagnosis.

Approximate SynonymsGuidance

Alternate terms and clinical phrases that map to this code.

  • Addiction
  • Biting self
  • Compulsion expressed as ritual
  • Compulsion to act on dangerous thoughts
  • Compulsion to act on thoughts
  • Compulsive arrangement of objects
  • Compulsive behavior
  • Compulsive buying
  • Compulsive checking
  • Compulsive cleaning
  • Compulsive counting
  • Compulsive drug taking
  • Compulsive handwashing
  • Compulsive hoarding
  • Compulsive purposeless behavior
  • Compulsive repeating
  • Compulsive scratching behavior
  • Compulsive self-biting behavior
  • Compulsive tidying
  • Compulsive touching
  • Compulsive uncontrollable drug taking
  • Compulsive washing
  • Compulsive water drinking
  • Excessive exercise
  • Exercise history finding
  • Finding related to ability to resist dangerous thoughts
  • Finding related to ability to resist obsessional thoughts
  • Finding related to ability to resist thoughts
  • Hoarding
  • Inability to resist compulsive behaviors
  • Obsessive behavior
  • Psychological addiction
  • Scratches self
  • Unable to resist dangerous thoughts
  • Unable to resist obsessional thoughts

Tabular List NotesGuidance

Coding notes and annotation back-references applicable to this code.

Type 1 Excludes

  • obsessive-compulsive disorder F42

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.

    • Behavior
      • obsessive-compulsive

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 No · outpatient Yes

Clinical InformationClinical

  • Compulsive Behavior

    the behavior of performing an act persistently and repetitively without it leading to reward or pleasure. the act is usually a small, circumscribed behavior, almost ritualistic, yet not pathologically disturbing. examples of compulsive behavior include twirling of hair, checking something constantly, not wanting pennies in change, straightening tilted pictures, etc.
  • Hoarding

    a persistent difficulty discarding or parting with possessions.
  • Hoarding Disorder

    disordered behavior associated with clinically significant distress or impairment in social, occupational or other important areas of functioning and persistent difficulty parting with possessions due to a perceived need to save the items and distress associated with discarding them. (from dsm-v) the quantity of collected items sets the behavior apart from normal collecting behaviors.
  • Obsessive Behavior

    persistent, unwanted idea or impulse which is considered normal when it does not markedly interfere with mental processes or emotional adjustment.

Patient EducationClinical

Obsessive-Compulsive Disorder

Obsessive-compulsive disorder (OCD) is a mental disorder in which you have thoughts (obsessions) and rituals (compulsions) over and over. They interfere with your life, but you cannot control or stop them.

The full article covers:

  • What is obsessive-compulsive disorder (OCD)?
  • What causes obsessive-compulsive disorder (OCD)?
  • Who is at risk for obsessive-compulsive disorder (OCD)?
  • What are the symptoms of obsessive-compulsive disorder (OCD)?
  • How is obsessive-compulsive disorder (OCD) diagnosed?
  • What are the treatments for obsessive-compulsive disorder (OCD)?

Read the full article at MedlinePlus

Courtesy of MedlinePlus, a service of the U.S. National Library of Medicine.

Convert R46.81 to ICD-9-CMHistory

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

ICD-9-CM
799.89 Ill-define condition NEC
Approximate The match is approximate rather than exact.
ICD-9-CM
V40.39 Oth spc behavior problem
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 R46.81Overview

Is R46.81 (Other symptoms and signs involving appearance and behavior) a billable code?

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

Can R46.81 be a principal diagnosis?

No. The Medicare Code Editor rejects this code as a principal diagnosis because obsessive-compulsive behavior describes a circumstance that influences health status rather than a current illness. Report it as a secondary diagnosis.

What is the ICD-9 equivalent of R46.81?

Under the General Equivalence Mappings, obsessive-compulsive behavior converts to ICD-9-CM 799.89 (ill-define condition NEC) and V40.39 (oth spc behavior problem). 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.