Is R40.2242 a billable ICD-10-CM code?

Yes. R40.2242 is a billable, specific ICD-10-CM code and is valid for submission on a claim.

Where does R40.2242 sit in the tabular list?

Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R99), in the block Symptoms and signs involving cognition, perception, emotional state and behavior (R40-R46).

R40.2242

R40.2242 — Coma scale, best verbal response, confused conversation, at arrival to emergency department

Billable / specific codeICD-10-CM

R40.2242 is a billable, specific ICD-10-CM code for coma scale, best verbal response, confused conversation, at arrival to emergency department. It is valid for submission on a claim.

7th character "2" — at arrival to emergency department

The following appropriate 7th character is to be added to subcategory R40.22-:

0: unspecified time
1: in the field [EMT or ambulance]
2: at arrival to emergency department
3: at hospital admission
4: 24 hours or more after hospital admission

Inclusion terms

Alternative wordings a physician may use in the chart for this same code.

Coma scale verbal score of 4
Inappropriate words (2-5 years of age)
Irritable cries (< 2 years of age)

Risk adjustment

R40.2242 does not map to an HCC and does not risk-adjust under CMS-HCC V28. That is normal — most ICD-10 codes do not. It still needs to be coded correctly; it just will not move a RAF score.

Medicare coverage

R40.2242 is named in 1 Medicare coverage policy — 1 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.

A56645Billing and Coding: Controlled Substance Monitoring and Drugs of Abuse Testing

Code history

R40.2242 has not changed since FY2024 — no addition, revision or deletion across the three most recent ICD-10-CM releases.

Related codes at this level

Codes that share R40.224. If R40.2242 is not quite right, the correct code is usually one of these.

Questions about R40.2242

Is R40.2242 a billable ICD-10-CM code?: Yes. R40.2242 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
Where does R40.2242 sit in the tabular list?: Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R99), in the block Symptoms and signs involving cognition, perception, emotional state and behavior (R40-R46).