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    OpenPayerBilling CodesSymptoms and signs involving cognition, perception, emotional state and behaviorICD-10-CM r46-symptoms-and-signs-appearance-behavior
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    ICD-10-CM Code For Symptoms And Signs Involving Appearance And Behavior: Group Overview

    The International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) code group R46 includes signs and symptoms related to appearance, affect, behavior, and social functioning such as abnormal facial appearance, lack of normal emotional response, and inappropriate affect or conduct. These ICD-10-CM diagnosis codes are used to document observable behavioral and appearance-related findings that inform clinical evaluation and care planning, capturing clinical complexity and the need for further assessment. Accurate coding within the ICD-10-CM R46 group supports proper claim adjudication and complete clinical documentation.

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    ICD-10-CM R46: Symptoms And Signs Involving Appearance And Behavior Overview

    The diagnoses in the ICD-10-CM R46 group represent signs and symptoms related to a patient’s appearance, behavior, emotional state, and aspects of social functioning rather than specific diagnosed mental disorders. These codes target observations such as abnormal facial appearance, lack of normal emotional response, and inappropriate affect or behavior that may be relevant across medical and psychiatric settings. Accurate coding matters for reimbursement because it documents clinical complexity and supports the medical necessity of further evaluation and treatment.

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    When to Use

    Use codes from this group when clinicians document observable appearance or behavior findings that are relevant to the encounter and not otherwise specified by a definitive diagnosis. These codes apply when such signs influence clinical decision making, require further evaluation, or need to be recorded to support care coordination and documentation.

    ICD-10-CM Codes

    10 rows

    ICD-10-CM CodeDescription
    R46.0Very low level of personal hygiene
    R46.1Bizarre personal appearance
    R46.2Strange and inexplicable behavior
    R46.3Overactivity
    R46.4Slowness and poor responsiveness
    R46.5Suspiciousness and marked evasiveness
    R46.6Undue concern and preoccupation with stressful events
    R46.7Verbosity and circumstantial detail obscuring reason for contact
    R46.81Obsessive-compulsive behavior
    R46.89Other symptoms and signs involving appearance and behavior

    DRG Codes

    1 rows

    DRG CodeDescription
    951Other Factors Influencing Health Status

    Typical Clinical Scenarios

    • An elderly patient is brought to the emergency department by family after acute onset of confused behavior, disorientation to time and place, and disorganized speech following a urinary tract infection. The clinician documents altered mental status with observable confusion and behavioral disturbance; a symptom-level code from this group is assigned when no primary neurocognitive disorder is yet established and the presentation reflects acute changes in appearance and behavior. Typical codes: R46.0, R46.1
    • A middle-aged outpatient reports persistent lack of eye contact, markedly diminished facial expression, and slowed movements over months, causing social and occupational impairment; psychiatric evaluation finds prominent affective blunting without a diagnosed psychotic disorder. Because the findings are signs involving appearance and behavior noted on exam and not attributable to another specific mental disorder, a code from this group is used to capture the observed abnormality. Typical codes: R46.81, R46.2
    • A hospitalized patient with advanced Parkinson disease develops severe masked facies and reduced spontaneous movements, complicating nutrition and communication; neurology documents hypomimia and decreased gesturing as physical signs worsening functional status. These observable motor and facial expression abnormalities are coded from this group as comorbid signs that affect care and recovery. Typical codes: R46.2, R46.3

    Related Codes

    R40-SOMNOLENCE-STUPOR-AND-COMA

    ICD-10-CM Code For Somnolence Stupor And Coma: Group Overview

    R41-OTHER-SYMPTOMS-AND-SIGNS-COGNITIVE

    ICD-10-CM Code For Other Symptoms And Signs Involving Cognitive Functions And Awareness: Group Overview

    R42-DIZZINESS-AND-GIDDINESS

    ICD-10-CM Code For Dizziness And Giddiness: Group Overview

    R43-DISTURBANCES-OF-SMELL-AND-TASTE

    ICD-10-CM Code For Disturbances Of Smell And Taste: Group Overview

    R44-OTHER-SYMPTOMS-AND-SIGNS

    ICD-10-CM Code For Other Symptoms And Signs Involving General Sensations And Perceptions: Group Overview

    R45-SYMPTOMS-AND-SIGNS-EMOTIONAL-STATE

    ICD-10-CM Code For Symptoms And Signs Involving Emotional State: Group Overview

    Frequently Asked Questions

    References

    1. 1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
    2. 2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
    3. 3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.
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