ICD-10 Coding for Complex Partial Seizure(G40.209, G40.219)
Complete ICD-10-CM coding and documentation guide for Complex Partial Seizure. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Complex Partial Seizure
G40.2-G40.9Primary Range
Epilepsy and recurrent seizures
This range includes codes for different types of epilepsy and seizures, including complex partial 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 |
|---|---|---|---|
| G40.209 | Complex partial seizures, not intractable, without status epilepticus | Use when complex partial seizures are documented as not intractable and without status epilepticus. |
|
| G40.219 | Complex partial seizures, intractable, without status epilepticus | Use when complex partial seizures are documented as intractable. |
|
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 complex partial seizures
Essential facts and insights about Complex Partial Seizure
Primary ICD-10-CM Codes for complex partial seizure
Decision Criteria
clinical Criteria
- EEG shows focal discharges without intractability
documentation Criteria
- Seizure type and status clearly documented
Applicable To
- Focal impaired awareness seizures
Excludes
- Generalized seizures (G40.3)
Clinical Validation Requirements
- EEG showing focal discharges
- No failure of ≥2 AEDs
- No prolonged seizure activity
Code-Specific Risks
- Incorrectly coding as generalized seizures
- Using unspecified codes like R56.9
Coding Notes
- Ensure documentation specifies seizure type and intractability status.
G40.219 - Complex partial seizures, intractable, without status epilepticus
Use when complex partial seizures are documented as intractable.
Applicable To
- Intractable focal impaired awareness seizures
Excludes
- Generalized seizures (G40.3)
Clinical Validation Requirements
- Documented failure of ≥2 AEDs
- Ongoing seizures despite adequate dosing/duration
Coding Notes
Ensure documentation includes AED failure details.
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 Complex Partial Seizure to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code G40.209.
Impact
Clinical: Inaccurate representation of seizure management., Regulatory: Non-compliance with coding standards., Financial: Potential for denied claims.
Mitigation Strategy
Ensure AED trials are documented in patient records., Review documentation before coding.
Impact
Reimbursement: May lead to reduced reimbursement due to lack of specificity., Compliance: Non-compliance with ICD-10 coding guidelines., Data Quality: Decreases accuracy of clinical data.
Mitigation Strategy
Use specific codes like G40.209 or G40.219 based on seizure type and intractability.
Impact
Risk of coding seizures without proper documentation of type and intractability.
Mitigation Strategy
Implement documentation checks for seizure type and AED trials.
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 Complex Partial Seizure, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Complex Partial Seizure
Use these documentation templates to ensure complete and accurate documentation for Complex Partial Seizure. These templates include all required elements for proper coding and billing.
Complex Partial Seizure Documentation
Specialty: NeurologyRequired Elements
- Seizure type
- Intractability status
- EEG findings
- AED trials
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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