Symptoms and signs involving appearance and behavior (R46) ICD-10-CM
The R46 code range covers symptoms and signs involving appearance and behavior with 12 ICD-10-CM diagnosis codes. 10 of them are billable and valid for claim submission in fiscal year 2026, and the category headers group them but cannot themselves be billed.
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.
Codes in the R46 Range 12 codes · 10 billable
- R46 Symptoms and signs involving appearance and behaviorNon-billable
- R46.0 Very low level of personal hygiene
- R46.1 Bizarre personal appearance
- R46.2 Strange and inexplicable behavior
- R46.3 Overactivity
- R46.4 Slowness and poor responsiveness
- R46.5 Suspiciousness and marked evasiveness
- R46.6 Undue concern and preoccupation with stressful events
- R46.7 Verbosity and circumstantial detail obscuring reason for contact
- R46.8 Other symptoms and signs involving appearance and behaviorNon-billable
- R46.81 Obsessive-compulsive behavior
- R46.89 Other symptoms and signs involving appearance and behavior
Clinical Terms in This Code Range
Definitions from the National Library of Medicine for conditions coded in the R46 range.
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.
About the R46 Code Range
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.
Questions About This Page
How many billable codes are in the R46 range?
Of the 12 codes in this range, 10 are billable and valid for claim submission from October 1, 2025 through September 30, 2026. Category header codes group them but cannot be reported on claims.
What does the R46 range classify?
The range classifies symptoms and signs involving appearance and behavior. Each code links to its own reference page with billing status, MS-DRG grouping, coding notes, and clinical information.
Related References
Source: CMS FY 2026 ICD-10-CM Tabular List and order file, effective October 1, 2025 through September 30, 2026.
