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  2. ICD-10-CM Codes List
  3. R00–R99
  4. R40-R46
  5. Symptoms and signs involving appearance and behavior (R46)

Symptoms and signs involving appearance and behavior (R46)

The R46 section of ICD-10-CM codes covers symptoms and signs related to an individual's appearance and behavior, including conditions like very low personal hygiene, bizarre personal appearance, and unusual behaviors. These codes help document observations often linked to mental or substance use conditions.

For example, R46.0 describes a very low level of personal hygiene, also called self-neglect or neglect of personal hygiene, useful when patients show poor cleanliness. R46.1 is used for bizarre personal appearance such as wearing inappropriate clothing or appearing disheveled. The code R46.2 identifies strange and inexplicable behavior, including actions like smearing feces. Other codes like R46.3 for overactivity and R46.81 for obsessive-compulsive behavior capture specific behavioral patterns. By using these specific ICD-10 codes for symptoms involving appearance and behavior, healthcare professionals can accurately record patient presentations that do not yet have a defined diagnosis but require clinical attention and monitoring.

Instructional Notations

Type 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.

  • appearance and behavior in schizophrenia, schizotypal and delusional disorders F20 F29
  • mental and behavioral disorders F01 F99

Clinical Terms

The following clinical terms provide additional context, helping users better understand the clinical background and common associations for each diagnosis listed in this section. Including related terms alongside ICD-10-CM codes supports coders, billers, and healthcare professionals in improving accuracy, enhancing documentation, and facilitating research or patient education.

Absenteeism

Chronic absence from work or other duty.

Agonistic Behavior

Any behavior associated with conflict between two individuals.

Cannibalism

Eating other individuals of one's own species.

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.

Criminal Behavior

Conduct leading to commission of unlawful acts.

Cytophagocytosis

The engulfment and degradation of cells by other cells.

Essential Tremor

A relatively common disorder characterized by a fairly specific pattern of tremors which are most prominent in the upper extremities and neck, inducing titubations of the head. The tremor is usually mild, but when severe may be disabling. An autosomal dominant pattern of inheritance may occur in some families (i.e., familial tremor). (Mov Disord 1988;13(1):5-10)

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.

Negativism

State of mind or behavior characterized by extreme skepticism and persistent opposition or resistance to outside suggestions or advice. (APA, Thesaurus of Psychological Index Terms, 1994)

Obsessive Behavior

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

Social Behavior

Any behavior caused by or affecting another individual or group usually of the same species.

Social Behavior Disorders

Behaviors which are at variance with the expected social norm and which affect other individuals.