ICD-10 Coding for Psychogenic Nonepileptic Seizure(F44.5, R56.9)
Complete ICD-10-CM coding and documentation guide for Psychogenic Nonepileptic Seizure. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Psychogenic Nonepileptic Seizure
F44.0-F44.9Primary Range
Dissociative and conversion disorders
This range includes conversion disorders, with F44.5 specifically for PNES.
Convulsions, not elsewhere classified
Used when seizures are suspected but not confirmed as PNES.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| F44.5 | Conversion disorder with seizures or convulsions | Use when PNES is confirmed by video-EEG and psychological factors are documented. |
|
| R56.9 | Unspecified convulsions | Use when video-EEG is pending or inconclusive. |
|
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 psychogenic nonepileptic seizures
Essential facts and insights about Psychogenic Nonepileptic Seizure
Primary ICD-10-CM Codes for psychogenic nonepileptic seizure
Decision Criteria
clinical Criteria
- Video-EEG shows no epileptiform activity during events.
documentation Criteria
- Psychological stressors are documented.
Applicable To
- Psychogenic nonepileptic seizures
- Pseudoseizures
Excludes
- Epileptic seizures (G40.-)
Clinical Validation Requirements
- Video-EEG confirmation of non-epileptic origin
- Absence of epileptiform activity during events
- Documentation of psychological stressors
Code-Specific Risks
- Misdiagnosis as epilepsy
- Insufficient documentation of psychological factors
Coding Notes
- Ensure video-EEG results are documented to confirm PNES.
R56.9 - Unspecified convulsions
Use when video-EEG is pending or inconclusive.
Clinical Validation Requirements
- Use when seizures are suspected but not confirmed as PNES.
Coding Notes
Transition to F44.5 once PNES is confirmed.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Other somatoform disorders
F45.8Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Psychogenic Nonepileptic Seizure to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code F44.5.
Impact
Clinical: Leads to misdiagnosis and inappropriate treatment., Regulatory: Non-compliance with documentation standards., Financial: Potential claim denials due to insufficient documentation.
Mitigation Strategy
Provide detailed descriptions of seizure events., Ensure video-EEG results are included.
Impact
Reimbursement: Incorrect DRG assignment can affect reimbursement., Compliance: Non-compliance with ICD-10 guidelines., Data Quality: Inaccurate clinical data and statistics.
Mitigation Strategy
Ensure video-EEG confirms non-epileptic origin before coding F44.5.
Impact
Reimbursement: Potential claim denials due to lack of specificity., Compliance: Failure to adhere to coding guidelines., Data Quality: Ambiguous data affecting patient records.
Mitigation Strategy
Use R56.9 only when PNES is unconfirmed.
Impact
Inadequate documentation of video-EEG and psychological factors.
Mitigation Strategy
Implement standardized templates for documenting PNES.
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 Psychogenic Nonepileptic Seizure, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Psychogenic Nonepileptic Seizure
Use these documentation templates to ensure complete and accurate documentation for Psychogenic Nonepileptic Seizure. These templates include all required elements for proper coding and billing.
Patient with confirmed PNES
Specialty: NeurologyRequired Elements
- Event description
- Video-EEG results
- Psychological factors
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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