R40.2220: Coma scale, best verbal response, incomprehensible words, unspecified time
R40.2220, coma scale, best verbal response, incomprehensible words, unspecified time, is listed as a covered diagnosis in 8 Medicare billing and coding articles that apply to 31 HCPCS Level II codes, including G0480 (Drug test(s), definitive, utilizing (1) drug…), G0483 (Drug test(s), definitive, utilizing (1) drug…), G0482 (Drug test(s), definitive, utilizing (1) drug…). The articles come from 6 Medicare contractors. A listed diagnosis supports medical necessity only; coverage still depends on the LCD's criteria and on documentation in the medical record.
HCPCS Level II codes with R40.2220 as a covered diagnosis
| Code | Description | Medicare coverage | DMEPOS fee 2026 (state range) | Articles listing it |
|---|---|---|---|---|
| G0480 | Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not limited to gc/ms (any type, single or tandem) and lc/ms (any type, single or tandem and excluding immunoassays (e.g., ia, eia, elisa, emit, fpia) and enzymatic methods (e.g., alcohol dehydrogenase)), (2) stable isotope or other universally recognized internal standards in all samples (e.g., to control for matrix effects, interferences and variations in signal strength), and (3) method or drug-specific calibration and matrix-matched quality control material (e.g., to control for instrument variations and mass spectral drift); qualitative or quantitative, all sources, includes specimen validity testing, per day; 1-7 drug class(es), including metabolite(s) if performed | Carrier judgment | — | 6 |
| G0483 | Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not limited to gc/ms (any type, single or tandem) and lc/ms (any type, single or tandem and excluding immunoassays (e.g., ia, eia, elisa, emit, fpia) and enzymatic methods (e.g., alcohol dehydrogenase)), (2) stable isotope or other universally recognized internal standards in all samples (e.g., to control for matrix effects, interferences and variations in signal strength), and (3) method or drug-specific calibration and matrix-matched quality control material (e.g., to control for instrument variations and mass spectral drift); qualitative or quantitative, all sources, includes specimen validity testing, per day; 22 or more drug class(es), including metabolite(s) if performed | Carrier judgment | — | 6 |
| G0482 | Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not limited to gc/ms (any type, single or tandem) and lc/ms (any type, single or tandem and excluding immunoassays (e.g., ia, eia, elisa, emit, fpia) and enzymatic methods (e.g., alcohol dehydrogenase)), (2) stable isotope or other universally recognized internal standards in all samples (e.g., to control for matrix effects, interferences and variations in signal strength), and (3) method or drug-specific calibration and matrix-matched quality control material (e.g., to control for instrument variations and mass spectral drift); qualitative or quantitative, all sources, includes specimen validity testing, per day; 15-21 drug class(es), including metabolite(s) if performed | Carrier judgment | — | 6 |
| G0481 | Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not limited to gc/ms (any type, single or tandem) and lc/ms (any type, single or tandem and excluding immunoassays (e.g., ia, eia, elisa, emit, fpia) and enzymatic methods (e.g., alcohol dehydrogenase)), (2) stable isotope or other universally recognized internal standards in all samples (e.g., to control for matrix effects, interferences and variations in signal strength), and (3) method or drug-specific calibration and matrix-matched quality control material (e.g., to control for instrument variations and mass spectral drift); qualitative or quantitative, all sources, includes specimen validity testing, per day; 8-14 drug class(es), including metabolite(s) if performed | Carrier judgment | — | 6 |
| G0659 | Drug test(s), definitive, utilizing drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including but not limited to gc/ms (any type, single or tandem) and lc/ms (any type, single or tandem), excluding immunoassays (e.g., ia, eia, elisa, emit, fpia) and enzymatic methods (e.g., alcohol dehydrogenase), performed without method or drug-specific calibration, without matrix-matched quality control material, or without use of stable isotope or other universally recognized internal standard(s) for each drug, drug metabolite or drug class per specimen; qualitative or quantitative, all sources, includes specimen validity testing, per day, any number of drug classes | Carrier judgment | — | 6 |
| J2785 | Injection, regadenoson, 0.1 mg | Carrier judgment | — | 1 |
| J0461 | Injection, atropine sulfate, 0.01 mg | Special coverage instructions apply | — | 1 |
| J0153 | Injection, adenosine, 1 mg (not to be used to report any adenosine phosphate compounds) | Special coverage instructions apply | — | 1 |
| Q9957 | Injection, perflutren lipid microspheres, per ml | Carrier judgment | — | 1 |
| J1250 | Injection, dobutamine hydrochloride, per 250 mg | Special coverage instructions apply | — | 1 |
| J0280 | Injection, aminophyllin, up to 250 mg | Special coverage instructions apply | — | 1 |
| J1245 | Injection, dipyridamole, per 10 mg | Special coverage instructions apply | — | 1 |
| Q9956 | Injection, octafluoropropane microspheres, per ml | Carrier judgment | — | 1 |
| A9700 | Supply of injectable contrast material for use in echocardiography, per study | Special coverage instructions apply | — | 1 |
| C8921 | Transthoracic echocardiography with contrast, or without contrast followed by with contrast, for congenital cardiac anomalies; complete | Special coverage instructions apply | — | 1 |
| C8922 | Transthoracic echocardiography with contrast, or without contrast followed by with contrast, for congenital cardiac anomalies; follow-up or limited study | Special coverage instructions apply | — | 1 |
| C8923 | Transthoracic echocardiography with contrast, or without contrast followed by with contrast, real-time with image documentation (2d), includes m-mode recording, when performed, complete, without spectral or color doppler echocardiography | Special coverage instructions apply | — | 1 |
| C8924 | Transthoracic echocardiography with contrast, or without contrast followed by with contrast, real-time with image documentation (2d), includes m-mode recording, when performed, follow-up or limited study | Special coverage instructions apply | — | 1 |
| C8928 | Transthoracic echocardiography with contrast, or without contrast followed by with contrast, real-time with image documentation (2d), includes m-mode recording, when performed, during rest and cardiovascular stress test using treadmill, bicycle exercise and/or pharmacologically induced stress, with interpretation and report | Special coverage instructions apply | — | 1 |
| C8929 | Transthoracic echocardiography with contrast, or without contrast followed by with contrast, real-time with image documentation (2d), includes m-mode recording, when performed, complete, with spectral doppler echocardiography, and with color flow doppler echocardiography | Special coverage instructions apply | — | 1 |
| C8930 | Transthoracic echocardiography, with contrast, or without contrast followed by with contrast, real-time with image documentation (2d), includes m-mode recording, when performed, during rest and cardiovascular stress test using treadmill, bicycle exercise and/or pharmacologically induced stress, with interpretation and report; including performance of continuous electrocardiographic monitoring, with physician supervision | Special coverage instructions apply | — | 1 |
| Q9955 | Injection, perflexane lipid microspheres, per ml | Carrier judgment | — | 1 |
| G2187 | Patients with clinical indications for imaging of the head: head trauma | Carrier judgment | — | 1 |
| G2188 | Patients with clinical indications for imaging of the head: new or change in headache above 50 years of age | Carrier judgment | — | 1 |
| G2189 | Patients with clinical indications for imaging of the head: abnormal neurologic exam | Carrier judgment | — | 1 |
6 more codes are listed. See every code with payment by region in Caduvo.
Medicare policy articles listing R40.2220
- A57077: Billing and Coding: Controlled Substance Monitoring and Drugs of Abuse Testing (First Coast Service Options, Inc. (MAC - Part A, MAC - Part B); 5 Level II codes). LCD with the same title: L35006, L36393
- A55001: Billing and Coding: Urine Drug Testing (Noridian Healthcare Solutions, LLC (MAC - Part A, MAC - Part B); 5 Level II codes). LCD with the same title: L34645, L35724, L36029, L36668
- A56915: Billing and Coding: Urine Drug Testing (WPS Insurance Corporation (MAC - Part A, MAC - Part B); 5 Level II codes). LCD with the same title: L34645, L35724, L36029, L36668
- A59416: Billing and Coding: Urine Drug Testing (Wellpoint Federal (MAC - Part A, MAC - Part B); 5 Level II codes). LCD with the same title: L34645, L35724, L36029, L36668
- A54799: Billing and Coding: Urine Drug Testing (Palmetto GBA (MAC - Part A, MAC - Part B); 5 Level II codes). LCD with the same title: L34645, L35724, L36029, L36668
- A56818: Billing and Coding: Urine Drug Testing (CGS Administrators, LLC (MAC - Part A, MAC - Part B); 5 Level II codes). LCD with the same title: L34645, L35724, L36029, L36668
- A56781: Billing and Coding: Transthoracic Echocardiography (TTE) (Wellpoint Federal (MAC - Part A, MAC - Part B); 17 Level II codes). LCD with the same title: L33577, L34338
- A56612: Billing and Coding: CT of the Head (Palmetto GBA (MAC - Part A, MAC - Part B); 9 Level II codes). LCD with the same title: L34417
A diagnosis listed as covered in a billing and coding article supports medical necessity for the article's codes; it does not guarantee payment. Coverage depends on the LCD's criteria, the contractor's jurisdiction and documentation in the medical record.
Other R40 diagnoses (Somnolence, stupor and coma)
- R40.2221 — Coma scale, best verbal response, incomprehensible words, in the…
- R40.2222 — Coma scale, best verbal response, incomprehensible words, at arrival…
- R40.2223 — Coma scale, best verbal response, incomprehensible words, at…
- R40.2224 — Coma scale, best verbal response, incomprehensible words, 24 hours…
- R40.2210 — Coma scale, best verbal response, none, unspecified time
- R40.2211 — Coma scale, best verbal response, none, in the field [EMT or…
- R40.2212 — Coma scale, best verbal response, none, at arrival to emergency…
- R40.2213 — Coma scale, best verbal response, none, at hospital admission
- R40.2214 — Coma scale, best verbal response, none, 24 hours or more after…
- R40.20 — Unspecified coma
- R40.2110 — Coma scale, eyes open, never, unspecified time
- R40.2111 — Coma scale, eyes open, never, in the field [EMT or ambulance]
- R40.2112 — Coma scale, eyes open, never, at arrival to emergency department
- R40.2113 — Coma scale, eyes open, never, at hospital admission
- R40.2114 — Coma scale, eyes open, never, 24 hours or more after hospital…
- R40.2120 — Coma scale, eyes open, to pain, unspecified time
- R40.2121 — Coma scale, eyes open, to pain, in the field [EMT or ambulance]
- R40.2122 — Coma scale, eyes open, to pain, at arrival to emergency department
- R40.2123 — Coma scale, eyes open, to pain, at hospital admission
- R40.2124 — Coma scale, eyes open, to pain, 24 hours or more after hospital…
- R40.2310 — Coma scale, best motor response, none, unspecified time
- R40.2311 — Coma scale, best motor response, none, in the field [EMT or ambulance]
- R40.2312 — Coma scale, best motor response, none, at arrival to emergency…
- R40.2313 — Coma scale, best motor response, none, at hospital admission
- R40.2314 — Coma scale, best motor response, none, 24 hours or more after…
- R40.2320 — Coma scale, best motor response, extension, unspecified time
- R40.2321 — Coma scale, best motor response, extension, in the field [EMT or…
- R40.2322 — Coma scale, best motor response, extension, at arrival to emergency…
- R40.2323 — Coma scale, best motor response, extension, at hospital admission
- R40.2324 — Coma scale, best motor response, extension, 24 hours or more after…
Frequently asked questions
Does Medicare cover R40.2220 (Coma scale, best verbal response, incomprehensible words…)?
Medicare covers items and services, not diagnoses. 8 Medicare billing and coding articles list R40.2220 as a covered diagnosis for 31 HCPCS Level II codes: the diagnosis can support medical necessity for those codes, but payment still depends on the LCD's coverage criteria and the medical record.
Which HCPCS codes can be billed with ICD-10 R40.2220?
The Level II codes from the policies most specific to this diagnosis are G0480 (Drug test(s), definitive, utilizing (1) drug…, 6 articles); G0483 (Drug test(s), definitive, utilizing (1) drug…, 6 articles); G0482 (Drug test(s), definitive, utilizing (1) drug…, 6 articles); G0481 (Drug test(s), definitive, utilizing (1) drug…, 6 articles); G0659 (Drug test(s), definitive, utilizing drug identification…, 6 articles). Code choice depends on the item supplied; check each code's descriptor.
Which Medicare policy articles list R40.2220?
A57077 (Billing and Coding: Controlled Substance Monitoring and Drugs of Abuse Testing); A55001 (Billing and Coding: Urine Drug Testing); A56915 (Billing and Coding: Urine Drug Testing), and 5 more articles.
What is ICD-10-CM code R40.2220?
R40.2220 is the ICD-10-CM code for coma scale, best verbal response, incomprehensible words, unspecified time, in category R40 (Somnolence, stupor and coma), chapter 18: Symptoms, signs and abnormal findings.
Next steps
- Run a reimbursement report for a device billed under G0480
- Watch G0480 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for G0480
Sources: CMS Medicare Coverage Database billing and coding articles (covered ICD-10 code lists and HCPCS links); ICD-10-CM FY2026; CMS HCPCS Level II release October 2026; CMS DMEPOS fee schedule 2026 (non-rural state fees). Not billing or legal advice.
Chapter 18: Symptoms, signs and abnormal findings · All diagnoses · HCPCS lookup