2027 ICD-10-CM Diagnosis Code R46.81Obsessive-compulsive behavior

ICD-10-CM Codes›R00–R99›R40-R46›R46

ICD-10-CM R46.81
CMSSource: CMS FY 2027 ICD-10-CM dataset · Effective Oct 1, 2026 – Sep 30, 2027

R46.81 is a billable ICD-10-CM diagnosis code for obsessive-compulsive behavior. It is valid on HIPAA claims for fiscal year 2027 (October 1, 2026 through September 30, 2027) and groups to MS-DRG 951. 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
R46.8
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.

Unacceptable principal diagnosis
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

Instructional NotesGuidance

Instructions from the official ICD-10-CM Tabular List that apply to R46.81: its own notes plus those printed at R46, 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.

On R46.81 itself
  • obsessive-compulsive disorder (F42.-)
From R46 Symptoms and signs involving appearance and behavior applies to 10 codes
  • appearance and behavior in schizophrenia, schizotypal and delusional disorders (F20-F29)
  • mental and behavioral disorders (F01-F99)

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
  • symptoms and signs constituting part of a pattern of mental disorder (F01-F99)
From Chapter 18 (R00-R99) Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified applies to 774 codes
  • abnormal findings on antenatal screening of mother (O28.-)
  • certain conditions originating in the perinatal period (P04-P96)
  • signs and symptoms classified in the body system chapters
  • signs and symptoms of breast (N63, N64.5)

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.

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

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 2017–2026No changes
FY 2027CurrentCurrent code set, no changesEffective October 1, 2026 through September 30, 2027.

Questions About R46.81Overview

What is the ICD-10 code for obsessive-compulsive behavior?

The ICD-10-CM code for obsessive-compulsive behavior is R46.81 (sometimes written as R4681). It is billable on HIPAA-covered claims from October 1, 2026 through September 30, 2027.

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, 2026 through September 30, 2027.

What MS-DRG does R46.81 group to?

On inpatient claims, obsessive-compulsive behavior maps to MS-DRG 951 (other Factors Influencing Health Status), which carries a relative weight of 0.5574. Higher weights mean higher Medicare reimbursement.

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.

Can R46.81 be reported with a code from F42?

Not as a rule. The Excludes1 note on R46.81 lists "obsessive-compulsive disorder (F42.-)". 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).