Clinical Guidance Category

Unacceptable Principal Diagnosis Codes

ICD-10-CM codes identified as unacceptable when used as principal diagnosis by MCE edit logic.

Source: Definitions of Medicare Code Edits v43.1, edit 9.
Linked Diagnostic CodesPage 4 of 27 (2,651 total)
  • R29.736Billable

    NIHSS score 36

  • R29.737Billable

    NIHSS score 37

  • R29.738Billable

    NIHSS score 38

  • R29.739Billable

    NIHSS score 39

  • R29.740Billable

    NIHSS score 40

  • R29.741Billable

    NIHSS score 41

  • R29.742Billable

    NIHSS score 42

  • R40.2110Billable

    Coma scale, eyes open, never, unspecified time

  • R40.2111Billable

    Coma scale, eyes open, never, in the field [EMT or ambulance]

  • R40.2112Billable

    Coma scale, eyes open, never, at arrival to emergency department

  • R40.2113Billable

    Coma scale, eyes open, never, at hospital admission

  • R40.2114Billable

    Coma scale, eyes open, never, 24 hours or more after hospital admission

  • R40.2120Billable

    Coma scale, eyes open, to pain, unspecified time

  • R40.2121Billable

    Coma scale, eyes open, to pain, in the field [EMT or ambulance]

  • R40.2122Billable

    Coma scale, eyes open, to pain, at arrival to emergency department

  • R40.2123Billable

    Coma scale, eyes open, to pain, at hospital admission

  • R40.2124Billable

    Coma scale, eyes open, to pain, 24 hours or more after hospital admission

  • R40.2130Billable

    Coma scale, eyes open, to sound, unspecified time

  • R40.2131Billable

    Coma scale, eyes open, to sound, in the field [EMT or ambulance]

  • R40.2132Billable

    Coma scale, eyes open, to sound, at arrival to emergency department

  • R40.2133Billable

    Coma scale, eyes open, to sound, at hospital admission

  • R40.2134Billable

    Coma scale, eyes open, to sound, 24 hours or more after hospital admission

  • R40.2140Billable

    Coma scale, eyes open, spontaneous, unspecified time

  • R40.2141Billable

    Coma scale, eyes open, spontaneous, in the field [EMT or ambulance]

  • R40.2142Billable

    Coma scale, eyes open, spontaneous, at arrival to emergency department

  • R40.2143Billable

    Coma scale, eyes open, spontaneous, at hospital admission

  • R40.2144Billable

    Coma scale, eyes open, spontaneous, 24 hours or more after hospital admission

  • R40.2210Billable

    Coma scale, best verbal response, none, unspecified time

  • R40.2211Billable

    Coma scale, best verbal response, none, in the field [EMT or ambulance]

  • R40.2212Billable

    Coma scale, best verbal response, none, at arrival to emergency department

  • R40.2213Billable

    Coma scale, best verbal response, none, at hospital admission

  • R40.2214Billable

    Coma scale, best verbal response, none, 24 hours or more after hospital admission

  • R40.2220Billable

    Coma scale, best verbal response, incomprehensible words, unspecified time

  • R40.2221Billable

    Coma scale, best verbal response, incomprehensible words, in the field [EMT or ambulance]

  • R40.2222Billable

    Coma scale, best verbal response, incomprehensible words, at arrival to emergency department

  • R40.2223Billable

    Coma scale, best verbal response, incomprehensible words, at hospital admission

  • R40.2224Billable

    Coma scale, best verbal response, incomprehensible words, 24 hours or more after hospital admission

  • R40.2230Billable

    Coma scale, best verbal response, inappropriate words, unspecified time

  • R40.2231Billable

    Coma scale, best verbal response, inappropriate words, in the field [EMT or ambulance]

  • R40.2232Billable

    Coma scale, best verbal response, inappropriate words, at arrival to emergency department

  • R40.2233Billable

    Coma scale, best verbal response, inappropriate words, at hospital admission

  • R40.2234Billable

    Coma scale, best verbal response, inappropriate words, 24 hours or more after hospital admission

  • R40.2240Billable

    Coma scale, best verbal response, confused conversation, unspecified time

  • R40.2241Billable

    Coma scale, best verbal response, confused conversation, in the field [EMT or ambulance]

  • R40.2242Billable

    Coma scale, best verbal response, confused conversation, at arrival to emergency department

  • R40.2243Billable

    Coma scale, best verbal response, confused conversation, at hospital admission

  • R40.2244Billable

    Coma scale, best verbal response, confused conversation, 24 hours or more after hospital admission

  • R40.2250Billable

    Coma scale, best verbal response, oriented, unspecified time

  • R40.2251Billable

    Coma scale, best verbal response, oriented, in the field [EMT or ambulance]

  • R40.2252Billable

    Coma scale, best verbal response, oriented, at arrival to emergency department

  • R40.2253Billable

    Coma scale, best verbal response, oriented, at hospital admission

  • R40.2254Billable

    Coma scale, best verbal response, oriented, 24 hours or more after hospital admission

  • R40.2310Billable

    Coma scale, best motor response, none, unspecified time

  • R40.2311Billable

    Coma scale, best motor response, none, in the field [EMT or ambulance]

  • R40.2312Billable

    Coma scale, best motor response, none, at arrival to emergency department

  • R40.2313Billable

    Coma scale, best motor response, none, at hospital admission

  • R40.2314Billable

    Coma scale, best motor response, none, 24 hours or more after hospital admission

  • R40.2320Billable

    Coma scale, best motor response, extension, unspecified time

  • R40.2321Billable

    Coma scale, best motor response, extension, in the field [EMT or ambulance]

  • R40.2322Billable

    Coma scale, best motor response, extension, at arrival to emergency department

  • R40.2323Billable

    Coma scale, best motor response, extension, at hospital admission

  • R40.2324Billable

    Coma scale, best motor response, extension, 24 hours or more after hospital admission

  • R40.2330Billable

    Coma scale, best motor response, abnormal flexion, unspecified time

  • R40.2331Billable

    Coma scale, best motor response, abnormal flexion, in the field [EMT or ambulance]

  • R40.2332Billable

    Coma scale, best motor response, abnormal flexion, at arrival to emergency department

  • R40.2333Billable

    Coma scale, best motor response, abnormal flexion, at hospital admission

  • R40.2334Billable

    Coma scale, best motor response, abnormal flexion, 24 hours or more after hospital admission

  • R40.2340Billable

    Coma scale, best motor response, flexion withdrawal, unspecified time

  • R40.2341Billable

    Coma scale, best motor response, flexion withdrawal, in the field [EMT or ambulance]

  • R40.2342Billable

    Coma scale, best motor response, flexion withdrawal, at arrival to emergency department

  • R40.2343Billable

    Coma scale, best motor response, flexion withdrawal, at hospital admission

  • R40.2344Billable

    Coma scale, best motor response, flexion withdrawal, 24 hours or more after hospital admission

  • R40.2350Billable

    Coma scale, best motor response, localizes pain, unspecified time

  • R40.2351Billable

    Coma scale, best motor response, localizes pain, in the field [EMT or ambulance]

  • R40.2352Billable

    Coma scale, best motor response, localizes pain, at arrival to emergency department

  • R40.2353Billable

    Coma scale, best motor response, localizes pain, at hospital admission

  • R40.2354Billable

    Coma scale, best motor response, localizes pain, 24 hours or more after hospital admission

  • R40.2360Billable

    Coma scale, best motor response, obeys commands, unspecified time

  • R40.2361Billable

    Coma scale, best motor response, obeys commands, in the field [EMT or ambulance]

  • R40.2362Billable

    Coma scale, best motor response, obeys commands, at arrival to emergency department

  • R40.2363Billable

    Coma scale, best motor response, obeys commands, at hospital admission

  • R40.2364Billable

    Coma scale, best motor response, obeys commands, 24 hours or more after hospital admission

  • R40.2410Billable

    Glasgow coma scale score 13-15, unspecified time

  • R40.2411Billable

    Glasgow coma scale score 13-15, in the field [EMT or ambulance]

  • R40.2412Billable

    Glasgow coma scale score 13-15, at arrival to emergency department

  • R40.2413Billable

    Glasgow coma scale score 13-15, at hospital admission

  • R40.2414Billable

    Glasgow coma scale score 13-15, 24 hours or more after hospital admission

  • R40.2420Billable

    Glasgow coma scale score 9-12, unspecified time

  • R40.2421Billable

    Glasgow coma scale score 9-12, in the field [EMT or ambulance]

  • R40.2422Billable

    Glasgow coma scale score 9-12, at arrival to emergency department

  • R40.2423Billable

    Glasgow coma scale score 9-12, at hospital admission

  • R40.2424Billable

    Glasgow coma scale score 9-12, 24 hours or more after hospital admission

  • R40.2430Billable

    Glasgow coma scale score 3-8, unspecified time

  • R40.2431Billable

    Glasgow coma scale score 3-8, in the field [EMT or ambulance]

  • R40.2432Billable

    Glasgow coma scale score 3-8, at arrival to emergency department

  • R40.2433Billable

    Glasgow coma scale score 3-8, at hospital admission

  • R40.2434Billable

    Glasgow coma scale score 3-8, 24 hours or more after hospital admission

  • R40.2440Billable

    Other coma, without documented Glasgow coma scale score, or with partial score reported, unspecified time

  • R40.2441Billable

    Other coma, without documented Glasgow coma scale score, or with partial score reported, in the field [EMT or ambulance]

  • R40.2442Billable

    Other coma, without documented Glasgow coma scale score, or with partial score reported, at arrival to emergency department