ICD-10 Coding for Febrile Seizure(R56.00, R56.01)
Complete ICD-10-CM coding and documentation guide for Febrile Seizure. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Febrile Seizure
R56.0-R56.9Primary Range
Convulsions, not elsewhere classified
This range includes codes for febrile seizures, both simple and complex.
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 the seizure is generalized, lasts less than 15 minutes, and does not recur within 24 hours. |
|
| R56.01 | Complex febrile convulsions | Use when the seizure is prolonged, has focal features, or recurs 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 seizure
Essential facts and insights about Febrile Seizure
Primary ICD-10-CM Codes for febrile seizure
Decision Criteria
clinical Criteria
- Seizure is generalized and lasts less than 15 minutes
documentation Criteria
- No focal neurological signs documented
Applicable To
- Single episode
- Generalized seizure
Excludes
- Complex febrile convulsions (R56.01)
Clinical Validation Requirements
- Single episode lasting less than 15 minutes
- Generalized tonic-clonic seizure
- No focal neurological signs
Code-Specific Risks
- Misclassification if seizure duration or recurrence is not documented
Coding Notes
- Ensure documentation specifies the absence of focal features and recurrence.
R56.01 - Complex febrile convulsions
Use when the seizure is prolonged, has focal features, or recurs within 24 hours.
Applicable To
- Seizure lasting more than 15 minutes
- Focal neurological signs
- Recurrence within 24 hours
Excludes
- Simple febrile convulsions (R56.00)
Clinical Validation Requirements
- Seizure duration over 15 minutes
- Presence of focal neurological signs
- Recurrence within 24 hours
Coding Notes
Ensure documentation includes seizure duration, focality, and recurrence.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Postvaccination fever
T88.1Differential 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 Seizure to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code R56.00.
Impact
Clinical: Inaccurate clinical assessment, Regulatory: Non-compliance with documentation standards, Financial: Potential claim denials
Mitigation Strategy
Use standardized templates, Educate staff on documentation requirements
Impact
Reimbursement: Incorrect coding may lead to denied claims or incorrect reimbursement., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate clinical data affecting patient records.
Mitigation Strategy
Ensure detailed documentation of seizure duration, focality, and recurrence.
Impact
Incomplete documentation of seizure characteristics can lead to audit issues.
Mitigation Strategy
Implement thorough documentation practices and regular audits.
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 Seizure, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Febrile Seizure
Use these documentation templates to ensure complete and accurate documentation for Febrile Seizure. These templates include all required elements for proper coding and billing.
Febrile seizure in pediatric patient
Specialty: PediatricsRequired Elements
- Seizure duration
- Focal features
- Recurrence
- Fever documentation
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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