ICD-10 Coding for Generalized Convulsive Epilepsy(G40.301, G40.309, G40.311, G40.319)
Complete ICD-10-CM coding and documentation guide for Generalized Convulsive Epilepsy. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Generalized Convulsive Epilepsy
G40.3Primary Range
Generalized idiopathic epilepsy and epileptic syndromes
This range includes codes for generalized convulsive epilepsy, both intractable and not intractable, with or without status epilepticus.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| G40.301 | Generalized convulsive epilepsy, not intractable, with status epilepticus | Use when the patient has generalized convulsive epilepsy that is not intractable and has experienced status epilepticus. |
|
| G40.309 | Generalized convulsive epilepsy, not intractable, without status epilepticus | Use when the patient has generalized convulsive epilepsy that is not intractable and has not experienced status epilepticus. |
|
| G40.311 | Generalized convulsive epilepsy, intractable, with status epilepticus | Use when the patient has intractable generalized convulsive epilepsy with status epilepticus. |
|
| G40.319 | Generalized convulsive epilepsy, intractable, without status epilepticus | Use when the patient has intractable generalized convulsive epilepsy without status epilepticus. |
|
Clinical Decision Support
Always review the patient's clinical documentation thoroughly. When in doubt, choose the more specific code and ensure documentation supports it.
Key Information: ICD-10 code for generalized convulsive epilepsy
Essential facts and insights about Generalized Convulsive Epilepsy
Primary ICD-10-CM Codes for generalized convulsive epilepsy
Decision Criteria
clinical Criteria
- Presence of status epilepticus
documentation Criteria
- EEG confirmation of generalized onset
Applicable To
- Generalized tonic-clonic seizures with status epilepticus
Excludes
- Focal epilepsy (G40.2-)
Clinical Validation Requirements
- EEG confirmation of generalized onset
- Documentation of status epilepticus lasting >5 minutes
Code-Specific Risks
- Misclassification if status epilepticus is not documented
Coding Notes
- Ensure status epilepticus is clearly documented to use this code.
G40.309 - Generalized convulsive epilepsy, not intractable, without status epilepticus
Use when the patient has generalized convulsive epilepsy that is not intractable and has not experienced status epilepticus.
Applicable To
- Generalized tonic-clonic seizures without status epilepticus
Excludes
- Focal epilepsy (G40.2-)
Clinical Validation Requirements
- EEG confirmation of generalized onset
- Documentation of recurrent seizures
Coding Notes
Ensure absence of status epilepticus is clearly documented to use this code.
G40.311 - Generalized convulsive epilepsy, intractable, with status epilepticus
Use when the patient has intractable generalized convulsive epilepsy with status epilepticus.
Applicable To
- Intractable generalized tonic-clonic seizures with status epilepticus
Excludes
- Focal epilepsy (G40.2-)
Clinical Validation Requirements
- Failure of ≥2 appropriately dosed AEDs
- Documentation of status epilepticus lasting >5 minutes
Coding Notes
Ensure both intractability and status epilepticus are clearly documented to use this code.
G40.319 - Generalized convulsive epilepsy, intractable, without status epilepticus
Use when the patient has intractable generalized convulsive epilepsy without status epilepticus.
Applicable To
- Intractable generalized tonic-clonic seizures without status epilepticus
Excludes
- Focal epilepsy (G40.2-)
Clinical Validation Requirements
- Failure of ≥2 appropriately dosed AEDs
- Documentation of recurrent seizures
Coding Notes
Ensure intractability is clearly documented to use this code.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Noncompliance with medical treatment
Z91.83Differential Codes
Alternative codes to consider when ruling out similar conditions to the primary diagnosis.
Generalized convulsive epilepsy, not intractable, without status epilepticus
G40.309Generalized convulsive epilepsy, not intractable, with status epilepticus
G40.301Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Generalized Convulsive Epilepsy to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code G40.301.
Impact
Clinical: May lead to inappropriate treatment decisions., Regulatory: Fails to meet documentation standards., Financial: Potential for claim denial due to lack of specificity.
Mitigation Strategy
Always specify seizure type and frequency., Include EEG and imaging results if available.
Impact
Reimbursement: Incorrect coding may lead to denied claims or reduced reimbursement., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate clinical data affecting patient records.
Mitigation Strategy
Specify 'idiopathic' and seizure type to use the correct G40.3xx code.
Impact
Failure to document intractability can lead to incorrect coding.
Mitigation Strategy
Ensure documentation includes AED trials and response.
Documentation errors, coding pitfalls, and audit risks are interconnected aspects of medical coding and billing. Addressing all three areas helps ensure accurate coding, optimal reimbursement, and regulatory compliance.
Frequently Asked Questions
Common questions about ICD-10 coding for Generalized Convulsive Epilepsy, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Generalized Convulsive Epilepsy
Use these documentation templates to ensure complete and accurate documentation for Generalized Convulsive Epilepsy. These templates include all required elements for proper coding and billing.
Generalized Convulsive Epilepsy Follow-up
Specialty: NeurologyRequired Elements
- Seizure frequency and type
- EEG findings
- AED regimen and compliance
- Intractability status
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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