ICD-10 Coding for Partial Seizure(G40.209, G40.219)
Complete ICD-10-CM coding and documentation guide for Partial Seizure. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Partial Seizure
G40.0-G40.9Primary Range
Epilepsy and recurrent seizures
This range includes codes for different types of epilepsy and seizures, including 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 the patient has complex partial seizures that are not intractable and without status epilepticus. |
|
| G40.219 | Complex partial seizures, intractable, without status epilepticus | Use when the patient has complex partial seizures that are 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 partial seizures
Essential facts and insights about Partial Seizure
Primary ICD-10-CM Codes for partial seizure
Decision Criteria
clinical Criteria
- Patient has complex partial seizures without intractability.
Applicable To
- Complex partial seizures without intractability
Excludes
- Simple partial seizures
Clinical Validation Requirements
- EEG showing focal epileptiform discharges
- Clinical history of complex partial seizures
Code-Specific Risks
- Misclassification if intractability is not assessed
Coding Notes
- Ensure documentation specifies the type of partial seizure and intractability status.
G40.219 - Complex partial seizures, intractable, without status epilepticus
Use when the patient has complex partial seizures that are intractable.
Applicable To
- Intractable complex partial seizures
Excludes
- Simple partial seizures
Clinical Validation Requirements
- Documented failure of two or more antiepileptic drugs
- EEG or clinical evidence of complex partial seizures
Coding Notes
Ensure documentation includes intractability and failure of multiple medications.
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 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: Misrepresents current clinical status, Regulatory: Potential non-compliance with coding standards, Financial: May affect reimbursement if active treatment is not documented
Mitigation Strategy
Ensure active conditions are documented as such, Regularly update patient records with current status
Impact
Reimbursement: May lead to lower reimbursement rates, Compliance: Non-compliance with coding guidelines, Data Quality: Decreased accuracy in clinical data
Mitigation Strategy
Ensure seizure type is specified in documentation and use the appropriate specific code.
Impact
Risk of coding seizures as unspecified when specific type is documented.
Mitigation Strategy
Implement regular training on seizure documentation and 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 Partial Seizure, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Partial Seizure
Use these documentation templates to ensure complete and accurate documentation for Partial Seizure. These templates include all required elements for proper coding and billing.
Intractable Focal Epilepsy
Specialty: NeurologyRequired Elements
- Seizure type and frequency
- Intractability status
- Medication history
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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