ICD-10-CM 2027
ICD-10 code for coma
From the official ICD-10-CM alphabetic index entry “Coma”. Page updated September 29, 2026.
About coding coma
The ICD-10-CM code for coma is R40.20 (Unspecified coma). The official index lists 52 more specific codes, so check the documentation for details such as type, cause, site or severity before settling on R40.20.
Within R40.2, choose R40.20 (Unspecified coma) only when documentation doesn't support a more specific option: scale, eyes open (R40.21), scale, best verbal response (R40.22), scale, best motor response (R40.23), Glasgow coma scale, total score (R40.24) and nontraumatic coma due to underlying condition (R40.2A).
As a secondary diagnosis it is an MCC (major complication or comorbidity), which can move an inpatient stay into the highest-paying "with MCC" MS-DRG of its family, unless the principal diagnosis excludes it.
In MS-DRG v44.0, it is part of the grouping logic for DRG 080 (Nontraumatic Stupor and Coma with MCC, relative weight 1.7472), DRG 081 (Nontraumatic Stupor and Coma without MCC, relative weight 0.806), DRG 791 (Prematurity with Major Problems, relative weight 4.1075) and DRG 793 (Full Term Neonate with Major Problems, relative weight 4.2195), in MDC 01 (Diseases and Disorders of the Nervous System) and MDC 15 (Newborns and Other Neonates with Conditions Originating in the Perinatal Period), as a principal or secondary diagnosis. The DRG a claim lands in depends on the principal diagnosis, procedures and any CC/MCC secondary diagnoses.
More specific coma codes (official index)
- with
- motor response (none) R40.231 — Coma scale, best motor response, none
- abnormal R40.233 — Coma scale, best motor response, abnormal flexion
- abnormal extensor posturing to pain or noxious stimuli (< 2 years of age) R40.232 — Coma scale, best motor response, extension
- abnormal flexure posturing to pain or noxious stimuli (0-5 years of age) R40.233 — Coma scale, best motor response, abnormal flexion
- extension R40.232 — Coma scale, best motor response, extension
- extensor posturing to pain or noxious stimuli (2-5 years of age) R40.232 — Coma scale, best motor response, extension
- flexion/decorticate posturing (< 2 years of age) R40.233 — Coma scale, best motor response, abnormal flexion
- flexion withdrawal R40.234 — Coma scale, best motor response, flexion withdrawal
- localizes pain (2-5 years of age) R40.235 — Coma scale, best motor response, localizes pain
- normal or spontaneous movement (< 2 years of age) R40.236 — Coma scale, best motor response, obeys commands
- obeys commands (2-5 years of age) R40.236 — Coma scale, best motor response, obeys commands
- score of
- 1 R40.231 — Coma scale, best motor response, none
- 2 R40.232 — Coma scale, best motor response, extension
- 3 R40.233 — Coma scale, best motor response, abnormal flexion
- 4 R40.234 — Coma scale, best motor response, flexion withdrawal
- 5 R40.235 — Coma scale, best motor response, localizes pain
- 6 R40.236 — Coma scale, best motor response, obeys commands
- withdraws from pain or noxious stimuli (0-5 years of age) R40.234 — Coma scale, best motor response, flexion withdrawal
- withdraws to touch (< 2 years of age) R40.235 — Coma scale, best motor response, localizes pain
- opening of eyes (never) R40.211 — Coma scale, eyes open, never
- in response to
- pain R40.212 — Coma scale, eyes open, to pain
- sound R40.213 — Coma scale, eyes open, to sound
- score of
- 1 R40.211 — Coma scale, eyes open, never
- 2 R40.212 — Coma scale, eyes open, to pain
- 3 R40.213 — Coma scale, eyes open, to sound
- 4 R40.214 — Coma scale, eyes open, spontaneous
- spontaneous R40.214 — Coma scale, eyes open, spontaneous
- verbal response (none) R40.221 — Coma scale, best verbal response, none
- confused conversation R40.224 — Coma scale, best verbal response, confused conversation
- cooing or babbling or crying appropriately (< 2 years of age) R40.225 — Coma scale, best verbal response, oriented
- inappropriate crying or screaming (< 2 years of age) R40.223 — Coma scale, best verbal response, inappropriate words
- inappropriate words R40.223 — Coma scale, best verbal response, inappropriate words
- inappropriate words (2-5 years of age) R40.224 — Coma scale, best verbal response, confused conversation
- incomprehensible sounds (2-5 years of age) R40.222 — Coma scale, best verbal response, incomprehensible words
- incomprehensible words R40.222 — Coma scale, best verbal response, incomprehensible words
- irritable cries (< 2 years of age) R40.224 — Coma scale, best verbal response, confused conversation
- moans/grunts to pain; restless (<2 years old) R40.222 — Coma scale, best verbal response, incomprehensible words
- oriented R40.225 — Coma scale, best verbal response, oriented
- score of
- 1 R40.221 — Coma scale, best verbal response, none
- 2 R40.222 — Coma scale, best verbal response, incomprehensible words
- 3 R40.223 — Coma scale, best verbal response, inappropriate words
- 4 R40.224 — Coma scale, best verbal response, confused conversation
- 5 R40.225 — Coma scale, best verbal response, oriented
- screaming (2-5 years of age) R40.223 — Coma scale, best verbal response, inappropriate words
- uses appropriate words (2- 5 years of age) R40.225 — Coma scale, best verbal response, oriented
- eclamptic
- epileptic
- Glasgow, scale score
- hepatic
- hyperglycemic (diabetic)
- hyperosmolar (diabetic)
- hypoglycemic (diabetic)
- nondiabetic E15 — Nondiabetic hypoglycemic coma
- in diabetes
- insulin-induced
- ketoacidotic (diabetic)
- myxedematous E03.5 — Myxedema coma
- newborn P91.5 — Neonatal coma
- nontraumatic, due to underlying condition R40.2A — Nontraumatic coma due to underlying condition
- persistent vegetative state R40.3 — Persistent vegetative state
- secondary R40.2A — Nontraumatic coma due to underlying condition
- specified NEC, without documented Glasgow coma scale score, or with partial Glasgow coma scale score reported R40.244 — Other coma, without documented Glasgow coma scale score, or with partial score reported
Common questions about coma ICD-10 codes
What is the ICD-10 code for coma?
- R40.20 — Unspecified coma. More specific codes apply when the documentation supports them: R40.231, R40.233, R40.232, R40.233 and others below.
What is the ICD-10 code for myxedematous coma?
- E03.5 — Myxedema coma.
What is the ICD-10 code for newborn coma?
- P91.5 — Neonatal coma.
What is the ICD-10 code for persistent vegetative state coma?
- R40.3 — Persistent vegetative state.
What is the ICD-10 code for secondary coma?
- R40.2A — Nontraumatic coma due to underlying condition.
Is R40.20 billable?
- Yes. R40.20 is a billable/specific ICD-10-CM code valid for FY2027 (October 1, 2026 – September 30, 2027).
Can R40.20 be used as a principal diagnosis?
- Yes. The Medicare Code Editor doesn't restrict R40.20 as a principal diagnosis.
Is R40.20 a CC or MCC?
- R40.20 is an MCC (major complication or comorbidity) under MS-DRG v44.0, unless excluded by the principal diagnosis.