ICD-10 Coding for History of Seizures(Z86.79, G40.909, R56.9)
Complete ICD-10-CM coding and documentation guide for History of Seizures. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to History of Seizures
Z86.79Primary Range
Personal history of other diseases of the nervous system
Used for documenting resolved seizure conditions no longer requiring treatment.
Convulsions, not elsewhere classified
Used for acute seizure episodes without a history of 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 |
|---|---|---|---|
| Z86.79 | Personal history of other diseases of the nervous system | Use when documenting a resolved seizure condition with no current treatment. |
|
| G40.909 | Epilepsy, unspecified, not intractable | Use for active epilepsy cases with ongoing treatment. |
|
| R56.9 | Unspecified convulsions | Use for acute seizure episodes without a history of epilepsy. |
|
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 history of seizures
Essential facts and insights about History of Seizures
Primary ICD-10-CM Codes for history seizure
Decision Criteria
clinical Criteria
- No seizures and no AEDs for over 2 years
Applicable To
- History of resolved seizures
Excludes
- Active epilepsy (G40.-)
Clinical Validation Requirements
- No active seizures for ≥2 years
- Discontinuation of AEDs
Code-Specific Risks
- Incorrectly used for active seizure disorders
Coding Notes
- Ensure documentation clearly states the absence of active seizures and treatment.
G40.909 - Epilepsy, unspecified, not intractable
Use for active epilepsy cases with ongoing treatment.
Applicable To
- Active epilepsy
Excludes
- History of resolved seizures (Z86.79)
Clinical Validation Requirements
- EEG abnormalities
- Ongoing AED use
Coding Notes
Ensure active treatment and seizure activity are documented.
R56.9 - Unspecified convulsions
Use for acute seizure episodes without a history of epilepsy.
Applicable To
- Single acute seizure episode
Excludes
- Epilepsy (G40.-)
Clinical Validation Requirements
- Normal EEG
- No prior history of seizures
Coding Notes
Document the acute nature and lack of prior history.
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 History of Seizures to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code Z86.79.
Impact
Clinical: Misleading patient history, Regulatory: Non-compliance with documentation standards, Financial: Potential billing errors
Mitigation Strategy
Include specific dates, Document medication status
Impact
Reimbursement: Incorrect reimbursement rates due to misclassification., Compliance: Non-compliance with coding standards., Data Quality: Inaccurate patient health records.
Mitigation Strategy
Ensure active epilepsy is coded with G40.- series codes.
Impact
Misclassification of active epilepsy as history.
Mitigation Strategy
Regular audits and training on seizure coding.
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 History of Seizures, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for History of Seizures
Use these documentation templates to ensure complete and accurate documentation for History of Seizures. These templates include all required elements for proper coding and billing.
Resolved seizure history
Specialty: NeurologyRequired Elements
- Patient history
- Seizure-free duration
- Medication status
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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