ICD-10 Coding for Temporal Lobe Epilepsy(G40.001, G40.111)
Complete ICD-10-CM coding and documentation guide for Temporal Lobe Epilepsy. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Temporal Lobe Epilepsy
G40.001-G40.019Primary Range
Temporal lobe epilepsy and epileptic syndromes
This range includes specific codes for temporal lobe epilepsy, distinguishing between intractable and non-intractable forms, with or without status epilepticus.
Other focal (partial) epilepsy and epileptic syndromes
This range covers other types of focal epilepsy that may need differentiation from temporal lobe epilepsy.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| G40.001 | Localization-related (focal) (partial) epilepsy and epileptic syndromes with simple partial seizures, not intractable, without status epilepticus | Use when the patient has non-intractable temporal lobe epilepsy without status epilepticus. |
|
| G40.111 | Localization-related (focal) (partial) epilepsy and epileptic syndromes with complex partial seizures, intractable, with status epilepticus | Use when the patient has intractable temporal lobe epilepsy with 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 temporal lobe epilepsy
Essential facts and insights about Temporal Lobe Epilepsy
Primary ICD-10-CM Codes for temporal lobe epilepsy
Decision Criteria
clinical Criteria
- Patient has temporal lobe epilepsy without status epilepticus
Applicable To
- Non-intractable temporal lobe epilepsy without status
Excludes
- Intractable epilepsy (G40.111)
Clinical Validation Requirements
- EEG showing temporal lobe spikes
- No history of status epilepticus
Code-Specific Risks
- Misclassification if status epilepticus is present
Coding Notes
- Ensure documentation specifies the absence of status epilepticus and intractability.
G40.111 - Localization-related (focal) (partial) epilepsy and epileptic syndromes with complex partial seizures, intractable, with status epilepticus
Use when the patient has intractable temporal lobe epilepsy with status epilepticus.
Applicable To
- Intractable temporal lobe epilepsy with status
Excludes
- Non-intractable epilepsy (G40.001)
Clinical Validation Requirements
- EEG confirmation of temporal lobe origin
- Documented status epilepticus episodes
Coding Notes
Ensure documentation includes evidence of intractability and status epilepticus.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Differential Codes
Alternative codes to consider when ruling out similar conditions to the primary diagnosis.
Localization-related (focal) (partial) epilepsy and epileptic syndromes with complex partial seizures, intractable, with status epilepticus
G40.111Localization-related (focal) (partial) epilepsy and epileptic syndromes with simple partial seizures, not intractable, without status epilepticus
G40.001Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Temporal Lobe Epilepsy to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code G40.001.
Impact
Clinical: May lead to inappropriate treatment plans, Regulatory: Non-compliance with coding standards, Financial: Potential for reduced reimbursement
Mitigation Strategy
Use templates that prompt for intractability status, Regular training on epilepsy documentation
Impact
Reimbursement: May lead to lower reimbursement rates, Compliance: Non-compliance with coding guidelines, Data Quality: Decreased accuracy in patient records
Mitigation Strategy
Always specify the type of epilepsy and intractability status.
Impact
Risk of audits due to unspecified or incorrect epilepsy coding
Mitigation Strategy
Implement regular coding audits and training sessions.
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 Temporal Lobe Epilepsy, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Temporal Lobe Epilepsy
Use these documentation templates to ensure complete and accurate documentation for Temporal Lobe Epilepsy. These templates include all required elements for proper coding and billing.
Neurology Progress Note
Specialty: NeurologyRequired Elements
- Seizure semiology
- EEG findings
- MRI results
- Medication history
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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