ICD-10 Coding for Clonic Seizures(G40.40x, G40.111)
Complete ICD-10-CM coding and documentation guide for Clonic Seizures. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Clonic Seizures
G40.0-G40.9Primary Range
Epilepsy and recurrent seizures
This range includes codes for different types of epilepsy and seizures, including clonic seizures.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| G40.40x | Other generalized epilepsy, intractable | Use for recurrent generalized clonic seizures with treatment failure. |
|
| G40.111 | Localization-related symptomatic simple partial seizures, intractable | Use for focal clonic seizures that persist despite adequate AED trials. |
|
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 clonic seizures
Essential facts and insights about Clonic Seizures
Primary ICD-10-CM Codes for clonic seizures
Decision Criteria
clinical Criteria
- Generalized clonic seizures with failed treatment
Applicable To
- Recurrent generalized clonic seizures with treatment failure
Excludes
- Focal clonic seizures
Clinical Validation Requirements
- EEG showing generalized polyspike-wave discharges
- Documentation of treatment failure with ≥2 AEDs
Code-Specific Risks
- Incorrectly coding as focal seizures
Coding Notes
- Ensure documentation specifies intractability and EEG findings.
G40.111 - Localization-related symptomatic simple partial seizures, intractable
Use for focal clonic seizures that persist despite adequate AED trials.
Applicable To
- Focal clonic activity with treatment failure
Excludes
- Generalized clonic seizures
Clinical Validation Requirements
- Video-EEG confirming focal onset
- Documentation of ≥2 failed AEDs
Coding Notes
Document specific AEDs tried and failed.
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.
Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Clonic Seizures to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code G40.40x.
Impact
Clinical: Misdiagnosis and inappropriate treatment plans., Regulatory: Potential audit issues., Financial: Incorrect billing and reimbursement.
Mitigation Strategy
Use specific terminology like 'clonic jerks'., Document EEG and AED response.
Impact
Reimbursement: Incorrect DRG assignment leading to potential underpayment., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate clinical data affecting patient records.
Mitigation Strategy
Use G40.111 if intractable or G40.101 if drug-responsive.
Impact
Misclassification of seizure type can lead to incorrect coding.
Mitigation Strategy
Ensure detailed documentation and use of EEG findings.
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 Clonic Seizures, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Clonic Seizures
Use these documentation templates to ensure complete and accurate documentation for Clonic Seizures. These templates include all required elements for proper coding and billing.
Intractable Focal Clonic Seizures
Specialty: NeurologyRequired Elements
- Seizure description
- EEG findings
- AED response
- MRI/CT results
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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