ICD-10 Coding for Seizure Disorder(G40.909, R56.1, F44.5)
Complete ICD-10-CM coding and documentation guide for Seizure Disorder. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Seizure Disorder
G40-G47Primary Range
Epilepsy and recurrent seizures
This range includes codes for epilepsy and recurrent seizures, which are primary for seizure disorders.
Convulsions, not elsewhere classified
This range is used for convulsions not classified under epilepsy, such as single seizures.
Dissociative and conversion disorders
Includes psychogenic non-epileptic seizures (PNES), which are important differential diagnoses.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| G40.909 | Epilepsy, unspecified, not intractable, without status epilepticus | Use when epilepsy is confirmed but not further specified. |
|
| R56.1 | Post traumatic seizures | Use for seizures directly following traumatic brain injury. |
|
| F44.5 | Conversion disorder with seizures or convulsions | Use for seizures with psychological origin confirmed by video-EEG. |
|
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 seizure disorder
Essential facts and insights about Seizure Disorder
Primary ICD-10-CM Codes for seizure disorder
Decision Criteria
clinical Criteria
- Confirmed diagnosis of epilepsy with unspecified type.
Applicable To
- Unspecified epilepsy
Excludes
- R56.9 (Unspecified convulsions)
Clinical Validation Requirements
- EEG showing epileptiform activity
- Clinical history of ≥2 unprovoked seizures
Code-Specific Risks
- Overuse of unspecified codes can lead to audit risks.
Coding Notes
- Ensure documentation specifies seizure type and frequency.
R56.1 - Post traumatic seizures
Use for seizures directly following traumatic brain injury.
Applicable To
- Seizures following trauma
Excludes
- G40.XXX (Epilepsy)
Clinical Validation Requirements
- Seizure occurring ≤24h after trauma
- No prior history of epilepsy
Coding Notes
Ensure trauma is documented as the cause of the seizure.
F44.5 - Conversion disorder with seizures or convulsions
Use for seizures with psychological origin confirmed by video-EEG.
Applicable To
- Psychogenic non-epileptic seizures (PNES)
Excludes
- G40.XXX (Epilepsy)
Clinical Validation Requirements
- Video-EEG showing no epileptiform activity during events
Coding Notes
Documentation must confirm absence of epileptiform activity.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Unspecified abnormal involuntary movements
R25.9Differential Codes
Alternative codes to consider when ruling out similar conditions to the primary diagnosis.
Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Seizure Disorder to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code G40.909.
Impact
Clinical: Inaccurate treatment planning., Regulatory: Non-compliance with coding standards., Financial: Potential for reduced reimbursement.
Mitigation Strategy
Use templates to ensure complete documentation., Regular training on seizure documentation.
Impact
Reimbursement: Incorrect coding can lead to lower reimbursement., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate data on epilepsy prevalence.
Mitigation Strategy
Use G40.XXX for confirmed epilepsy with recurrent seizures.
Impact
Frequent use of unspecified codes can trigger audits.
Mitigation Strategy
Ensure detailed documentation of seizure characteristics.
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 Seizure Disorder, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Seizure Disorder
Use these documentation templates to ensure complete and accurate documentation for Seizure Disorder. These templates include all required elements for proper coding and billing.
Recurrent seizures in epilepsy
Specialty: NeurologyRequired Elements
- Seizure type
- Frequency
- Triggers
- Treatment response
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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