ICD-10 Coding for Infantile Spasms(G40.822, G40.823)
Complete ICD-10-CM coding and documentation guide for Infantile Spasms. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Infantile Spasms
G40.82Primary Range
Epileptic spasms
This range covers specific codes for epileptic spasms, including infantile spasms, which are critical for accurate diagnosis and treatment documentation.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| G40.822 | Epileptic spasms, not intractable, without status epilepticus | Use when infantile spasms are controlled with first-line therapy and no status epilepticus is present. |
|
| G40.823 | Epileptic spasms, not intractable, with status epilepticus | Use when infantile spasms are accompanied by status epilepticus. |
|
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 infantile spasms
Essential facts and insights about Infantile Spasms
Primary ICD-10-CM Codes for infantile spasms
Decision Criteria
clinical Criteria
- Presence of hypsarrhythmia on EEG
documentation Criteria
- Detailed description of spasm clusters
Applicable To
- Non-intractable infantile spasms
Excludes
- Intractable epileptic spasms (G40.812)
Clinical Validation Requirements
- EEG showing hypsarrhythmia
- Documented clusters of spasms
Code-Specific Risks
- Misclassification as general epilepsy
Coding Notes
- Ensure documentation specifies 'epileptic spasms' and not just 'seizures'.
G40.823 - Epileptic spasms, not intractable, with status epilepticus
Use when infantile spasms are accompanied by status epilepticus.
Applicable To
- Non-intractable infantile spasms with status epilepticus
Excludes
- Intractable epileptic spasms with status epilepticus (G40.813)
Clinical Validation Requirements
- EEG showing hypsarrhythmia
- Documented status epilepticus episodes
Coding Notes
Ensure status epilepticus is clearly documented.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Infantile Spasms to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code G40.822.
Impact
Clinical: Misdiagnosis risk., Regulatory: Non-compliance with documentation standards., Financial: Potential claim denials.
Mitigation Strategy
Use specific terminology like 'epileptic spasms'., Include detailed EEG findings.
Impact
Reimbursement: Incorrect DRG assignment, potential underpayment., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate clinical data representation.
Mitigation Strategy
Use G40.82- series for infantile spasms.
Impact
Lack of detailed EEG documentation can lead to audit issues.
Mitigation Strategy
Ensure all EEG findings are documented in detail.
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 Infantile Spasms, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Infantile Spasms
Use these documentation templates to ensure complete and accurate documentation for Infantile Spasms. These templates include all required elements for proper coding and billing.
Infantile Spasms Follow-Up
Specialty: NeurologyRequired Elements
- Spasm frequency
- EEG results
- Treatment response
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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