Persistent vegetative state

ICD10 Diagnosis
Dx:	Persistent vegetative state
ICD10 code:	R40.20
Pre-ICD10 counterpart:	Braindead, Anoxic Encephalopathy Post OP, Anoxic Encephalopathy Hanging, Anoxic Encephalopathy Post Arrest, Anoxic Encephalopathy 2nd to Trauma, Anoxic Encephalopathy Postictal, Anoxic Encephalopathy 2nd to hypoglycemia, Anoxic Encephalopathy 2nd to other, Diffuse axonal injury
Charlson/ALERT Scale:	none
APACHE Como Component:	none
APACHE Acute Component:	none
Start Date:
Stop Date:
External ICD10 Documentation	ICD-10 CM Wikipedia ICD-10 Wikipedia WHO ICD10 documentation ICD10data.com

This diagnosis is a part of ICD10 collection.

• SMW
  • 2019-01-01
  • 2999-12-31
  • R40.20

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Additional Info

Brain & Spinal Cord.org

Symptom/Sign/Test Result not needed when cause known

• This code identifies a symptom or a sign, or an abnormal test result, not a disorder.
  • So, you should code the cause of the symptom/sign/abnormal test, if known -- and if you do so, then also coding and combining the symptom/sign/abnormal test result to that cause is generally optional, but is guided by the following guidelines.
• Here are guidelines for whether or not to ALSO code the symptom/sign/abnormal test when you DO code the underlying cause:
  • If it is a subjective symptom (e.g. pain) then coding it is optional
  • When it is a physical exam finding (e.g. abdominal tenderness) then coding it is generally optional
    • An exception is when the symptom/sign/abnormal testis so severe that all by itself it mandates hospitalization and/or a procedure -- a good example is a patient who has Wegener's granulomatosis is admitted due with Hemoptysis. Since hemoptysis is a physical finding that fits this description of "severe" it should be coded, and combined with Wegener's.
  • When it is an abnormal laboratory finding which in and of itself has relevance (e.g. hyperkalemia, hypoalbuminemia) then USUALLY code it
    • You don't need to code the abnormal lab finding is when it is actually a major component of the underlying cause --- example is when a person presents with an acute MI, there is no need to code the abnormal troponin as Abnormal blood chemistry NOS
  • The trickiest of these guidelines is for abnormal radiologic tests
    • When the abnormal test is fully explained by the underlying diagnosis/diagnoses (e.g. pneumonia as cause of abnormal chest imaging, or a skull fracture with an intracranial hemorrhage both identified by an abnormal head CT) then coding the abnormal imaging result is optional
    • But remember there are some rare things for which the abnormal imaging result IS part of coding the entity, for example we code retroperitoneal hemorrhage by the combination of Hemorrhage, NOS and Retroperitoneal area, diagnostic imaging, abnormal
• Sometimes there may be multiple symptom/sign/test result that might or might NOT be related to each other by virtue of having the same underlying cause. Since in the absence of KNOWING that cause, such assumptions may well be incorrect, do NOT combine them together if you are not certain they actually have the same underlying cause.

Alternate ICD10s to consider coding instead or in addition

Candidate Combined ICD10 codes

• Anoxic brain injury, NOS
• Brain death
• Brain injury, diffuse (TBI), injury/trauma
• Brain, cerebral edema, injury/trauma
• Brain/intracranial injury NOS, injury/trauma
• Cerebral infarction/stroke, NOS
• Degenerative nervous system disorder, NOS
• Hyperglycemia
• Hemorrhage, intracerebral/intracranial, nontraumatic (ICH, hemorrhagic stroke)
• Hemorrhage, subarachnoid or ruptured cerebral aneurysm
• Intracranial hemorrhage, injury/trauma
• Meningitis, bacterial, NOS
• Meningitis, fungal
• Meningitis, infectious NOS
• Meningitis, viral - incl West Nile
• Status epilepticus (any seizure type)
• Myxedema with coma
• Noninfectious (aseptic) meningitis
• Paraneoplastic neuropathy or myopathy
• Subarachnoid hemorrhage, injury/trauma
• Subdural hemorrhage/hematoma, injury/trauma
• Brain or meninges, metastatic malignancy to it (also code primary site)
• Brain, primary malignancy
• toxicology

Related CCI Codes

Data Integrity Checks (automatic list)

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Show all ICD10 Subcategories

ICD10 Categories: ANCA-associated Vasculitis (AAV), Abdominal trauma, Abortion, Acute intoxication, Addiction, Adrenal Insufficiency, Adverse effect, Alcohol related, Allergy, Anemia, Anesthetic related, Aneurysm, Antibiotic resistance, Antidepressant related, Aortic Aneurysm, Arrhythmia, Arterial thromboembolism, Asthma, Atherosclerosis, Awaiting/delayed transfer, Bacteria, Benign neoplasm, Breast disease, Burn, COVID, Cannabis related, Cardiac septum problem, Cardiovascular, Cerebral Hemorrhage/Stroke, Chemical burn, Chronic kidney disease, Cirrhosis, Cocaine related, Decubitus ulcer, Delirium, Dementia, Diabetes, Diagnosis implying death, Double duty pathogen, ENT, Encephalitis, Encephalopathy, Endocrine disorder, Endocrine neoplasm, Exposure, Eye, Female genital neoplasm, Fistula, Fracture, Fungus, GI ulcer, Gastroenteritis, Gastrointestinal, Gastrointestinal neoplasm, Hallucinogen related, Has one, Head trauma, Head trauma (old), Healthcare contact, Heart valve disease, Heme/immunology, Heme/immunology neoplasm, Hemophilia, Hemorrhage, Hepatitis, Hereditary/congenital, Hernia, Hypertension, Hypotension, Iatrogenic, Iatrogenic infection, Iatrogenic mechanism, Imaging, Infection requiring pathogen, Infection with implied pathogen, Infectious disease, Inflammatory Bowel Disease, Influenza, Inhalation, Intra-abdominal infection, Ischemia, Ischemic gut, Ischemic heart disease, Joint/ligament trauma, Leukemia, Liver disease, Liver failure, Lower limb trauma, Lower respiratory tract infection, Lymphoma, Male genital neoplasm, Mechanism, Meningitis, Metabolic/nutrition, Metastasis, Misc, Muscle problem, Muscles/tendon trauma, Musculoskeletal/soft tissue, Musculoskeletal/soft tissue neoplasm... further results