ICD-10-CM 2026 · Effective October 1, 2025

ICD-10 R40.0

Billable / Specific

Somnolence

R40
Block
1
Synonyms
426
LCDs
30
Payer Policies
0
Linked CPTs

About ICD-10-CM R40.0

ICD-10-CM code R40.0 represents Somnolence. This is a billable/specific code in the Symptoms, Signs, and Abnormal Findings chapter (block R40). The 2026 edition of ICD-10-CM R40.0 became effective on October 1, 2025.

Inclusion Terms / Approximate Synonyms

Clinical terms and conditions classified under R40.0. Per CMS ICD-10-CM Tabular 2026.

  • Drowsiness

Type 1 Excludes

Pure excludes, these codes can never be coded together with R40.0. The conditions are mutually exclusive (e.g., congenital vs acquired forms).

  • coma (R40.2-)

Medicare LCD Coverage for R40.0

Local Coverage Determinations (LCDs) from CMS MACs that list R40.0 as a covered diagnosis.

426 LCDs

Showing top 10 of 426 total . Click a CPT for full coverage scope.

CMS LCD: Billing and Coding: Magnesium
Article ID: 59186, Effective: 2025-10-01 00:00:00, 4358 covered, 0 non-covered
CPT 83735 →
CMS LCD: Billing and Coding: Urine Drug Testing
Article ID: 59416, Effective: 2025-11-01 00:00:00, 428 covered, 0 non-covered
CPT G0480 →
CMS LCD: Billing and Coding: Urine Drug Testing
Article ID: 59416, Effective: 2025-11-01 00:00:00, 428 covered, 0 non-covered
CPT G0481 →
CMS LCD: Billing and Coding: Urine Drug Testing
Article ID: 59416, Effective: 2025-11-01 00:00:00, 428 covered, 0 non-covered
CPT G0482 →
CMS LCD: Billing and Coding: Urine Drug Testing
Article ID: 59416, Effective: 2025-11-01 00:00:00, 428 covered, 0 non-covered
CPT G0483 →
CMS LCD: Billing and Coding: Urine Drug Testing
Article ID: 59416, Effective: 2025-11-01 00:00:00, 428 covered, 0 non-covered
CPT 80305 →
CMS LCD: Billing and Coding: Urine Drug Testing
Article ID: 59416, Effective: 2025-11-01 00:00:00, 428 covered, 0 non-covered
CPT G0659 →
CMS LCD: Billing and Coding: Urine Drug Testing
Article ID: 59416, Effective: 2025-11-01 00:00:00, 428 covered, 0 non-covered
CPT 80307 →
CMS LCD: Billing and Coding: Urine Drug Testing
Article ID: 59416, Effective: 2025-11-01 00:00:00, 428 covered, 0 non-covered
CPT 80306 →
CMS LCD: Billing and Coding: Urine Drug Testing
Article ID: 55001, Effective: 2026-01-01 00:00:00, 388 covered, 0 non-covered
CPT G0480 →

Commercial Payer Coverage

Coverage policies from major commercial payers referencing R40.0.

30 policies

1 Cigna

Duplex Scan of Extracranial Arteries - (0542)
Policy ID: MM_0542

5 Medicare

Billing and Coding: Urine Drug Testing
Policy ID: ART-54799
Billing and Coding: Urine Drug Testing
Policy ID: ART-55001
Billing and Coding: CT of the Head
Policy ID: ART-56612
Billing and Coding: Psychiatric Inpatient Hospitalization
Policy ID: ART-56614
Billing and Coding: Nerve Conduction Studies and Electromyography
Policy ID: ART-56619

CPT Codes Commonly Billed with R40.0

Procedures frequently paired with this diagnosis based on PayerReady's Dx↔Px linkage data.

No procedure linkages on file for R40.0

We don't have CPT pairings indexed for this specific code yet. Use the CPT search above to find common procedures, or check your payer's published medical policy for code-specific guidance.

Convert R40.0 to ICD-9-CM

Per CMS General Equivalence Mappings (GEMs), useful for legacy data review and historical claim analysis.

ICD-10ICD-9Mapping Flags
R40.0 78009 10000

Flags format (5 digits): Approximate · No Map · Combination · Scenario · Choice List. Source: CMS 2017 GEMs (final version).

ICD-10 R40.0, Billing FAQ

Is ICD-10 code R40.0 billable? +

Yes, R40.0 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.

What other names or terms map to R40.0? +

ICD-10 R40.0 includes: Drowsiness.

What codes are Type 1 Excludes for R40.0? +

Type 1 Excludes (never code together with R40.0): coma (R40.2-)

What ICD-9 codes does R40.0 map to? +

Per CMS GEMs, R40.0 maps to ICD-9 codes: 78009. Useful for legacy data review and historical claim analysis.

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Reviewed by the PayerReady Medical Coding Team

Verified against the CMS 2026 code set on June 1, 2026.

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