ICD-10 Coding for Febrile Convulsion(R56.00, R56.01)
Complete ICD-10-CM coding and documentation guide for Febrile Convulsion. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Febrile Convulsion
R56.0-R56.9Primary Range
Convulsions, not elsewhere classified
This range includes codes for febrile convulsions, distinguishing between simple and complex cases.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| R56.00 | Simple febrile convulsions | Use when a child experiences a generalized seizure with fever, lasting less than 15 minutes, without recurrence within 24 hours. |
|
| R56.01 | Complex febrile convulsions | Use when a child experiences a seizure with focal features, lasting more than 15 minutes, or recurring within 24 hours. |
|
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 febrile convulsions
Essential facts and insights about Febrile Convulsion
Primary ICD-10-CM Codes for febrile convulsion
Decision Criteria
clinical Criteria
- Generalized seizure with fever, <15 minutes duration
Applicable To
- Generalized tonic-clonic seizure
- Duration <15 minutes
- No focal features
Clinical Validation Requirements
- Temperature ≥38°C
- Seizure duration <15 minutes
- No recurrence within 24 hours
Code-Specific Risks
- Misclassification with epilepsy codes
- Omitting documentation of fever
Coding Notes
- Ensure documentation specifies seizure type, duration, and fever presence.
R56.01 - Complex febrile convulsions
Use when a child experiences a seizure with focal features, lasting more than 15 minutes, or recurring within 24 hours.
Applicable To
- Focal seizure
- Duration >15 minutes
- Recurrence within 24 hours
Excludes
- Epilepsy (G40.-)
- Simple febrile convulsions (R56.00)
Clinical Validation Requirements
- Temperature ≥38°C
- Seizure duration >15 minutes
- Focal features or recurrence within 24 hours
Coding Notes
Document seizure characteristics and recurrence details.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Fever, unspecified
R50.9Differential 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 Febrile Convulsion to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code R56.00.
Impact
Clinical: Misclassification of seizure type., Regulatory: Non-compliance with ICD-10 guidelines., Financial: Potential claim denials.
Mitigation Strategy
Always document temperature readings., Include fever in the differential diagnosis.
Impact
Reimbursement: Incorrect coding may lead to denied claims., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate patient records.
Mitigation Strategy
Ensure documentation specifies fever presence and seizure type.
Impact
Failure to sequence underlying conditions before febrile seizure codes.
Mitigation Strategy
Educate coders on proper sequencing rules.
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 Febrile Convulsion, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Febrile Convulsion
Use these documentation templates to ensure complete and accurate documentation for Febrile Convulsion. These templates include all required elements for proper coding and billing.
Emergency Department Visit
Specialty: PediatricsRequired Elements
- Seizure type and duration
- Fever documentation
- Neurological exam findings
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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