Symptoms and signs involving cognition, perception, emotional state and behavior (R40-R46) ICD-10-CM
The R40–R46 section covers symptoms and signs involving cognition, perception, emotional state and behavior with 192 ICD-10-CM diagnosis codes, of which 157 are billable in fiscal year 2026. The section is organized into the 7 code ranges listed below.
Type 2 Excludes
A type 2 excludes note represents "Not included here". An excludes2 note indicates that the condition excluded is not part of the condition represented by the code, but a patient may have both conditions at the same time. When an Excludes2 note appears under a code, it is acceptable to use both the code and the excluded code together, when appropriate.
Code Ranges in This Section 7 ranges · 192 codes
The info icon previews the code ranges inside each row and its instructional notations from the official Tabular List.
About the R40–R46 Code Range
ICD-10 codes R40-R46 are used to classify various symptoms and signs involving cognition, perception, emotional state, and behavior. This range captures conditions such as altered levels of consciousness, cognitive deficits, emotional disturbances, and unusual behaviors.
These codes cover a wide spectrum, starting with R40 for somnolence, stupor, coma (including detailed coma scale scores), and persistent vegetative state. For example, R40.0 denotes somnolence, sometimes called excessive daytime sleepiness, while R40.2 specifies coma states. The section from R41 addresses cognitive symptoms like disorientation (acute confusion, delirium), amnesia (anterograde, retrograde), neurological neglect syndrome (anosognosia), and age-related cognitive decline. It also includes deficits in attention, communication, visuospatial, psychomotor, and executive functions. Codes in R42-R44 capture disturbances of sensation and perception such as dizziness (vertigo), and disorders of smell and taste, including anosmia and parosmia. The range also includes hallucinations with auditory (R44.0), visual (R44.1), or other sensory experiences. Emotional symptoms are coded in R45, encompassing nervousness, agitation, irritability, suicidal and homicidal thoughts, emotional lability, and self-harm behaviors. Lastly, R46 addresses symptoms involving appearance and behavior, such as poor personal hygiene, bizarre appearance, overactivity, suspiciousness, and obsessive-compulsive behaviors.
For medical coders, these codes provide precise classification for symptoms that impact neurological and psychological functioning but do not specify a particular diagnosis. They are essential when documenting symptoms like excessive drowsiness (disorder of excessive somnolence, post-ictal drowsiness coded under R40.0), confusion or delirium (disorientation under R41.0), or emotional instability (emotional lability, mood swings under R45.86). This detailed categorization supports accurate reporting of patient status affecting cognition, perception, mood, and behavior.
Questions About This Page
How many codes are in the R40-R46 range?
The R40-R46 range contains 192 ICD-10-CM diagnosis codes in FY 2026. 157 of them are billable, and the rest are category headers that organize the section.
What conditions does R40-R46 cover?
The range covers symptoms and signs involving cognition, perception, emotional state and behavior. The code ranges listed above break it into groups of related conditions, and each one links to its own page with the full code list.
Related References
Source: CMS FY 2026 ICD-10-CM Tabular List and order file, effective October 1, 2025 through September 30, 2026.
