ICD-10 Coding for Pseudoseizure(F44.5, R56.9)
Complete ICD-10-CM coding and documentation guide for Pseudoseizure. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Pseudoseizure
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| F44.5 | Conversion disorder with seizures or convulsions | Use when psychological etiology is confirmed and documented. |
|
| R56.9 | Unspecified convulsions | Use when pseudoseizures are documented without confirmation of conversion disorder. |
|
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 pseudoseizures
Essential facts and insights about Pseudoseizure
Primary ICD-10-CM Codes for pseudoseizure
Decision Criteria
clinical Criteria
- Psychological factors confirmed and documented.
documentation Criteria
- EEG shows no epileptiform activity during episodes.
Applicable To
- Psychogenic non-epileptic seizures
- Functional seizures
Excludes
- Epileptic seizures (G40.-)
Clinical Validation Requirements
- Video EEG confirms no epileptiform activity during events
- Psychological evaluation confirms stress or trauma
Code-Specific Risks
- Misclassification as epilepsy if not properly documented
- Incorrect reimbursement if psychological component is not specified
Coding Notes
- Ensure psychological component is documented to use F44.5.
R56.9 - Unspecified convulsions
Use when pseudoseizures are documented without confirmation of conversion disorder.
Applicable To
- Seizure NOS
Excludes
- Epileptic seizures (G40.-)
- Conversion disorder with seizures (F44.5)
Clinical Validation Requirements
- Lack of specific diagnosis linking to conversion disorder
- No psychological evaluation or stressor identified
Coding Notes
Default to R56.9 if documentation is vague; query provider for clarification.
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 Pseudoseizure to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code F44.5.
Impact
Clinical: Leads to inappropriate treatment plans., Regulatory: Increases risk of audit discrepancies., Financial: May result in incorrect billing and reimbursement.
Mitigation Strategy
Use terms like 'PNES' or 'functional seizures'., Ensure psychological evaluation is documented.
Impact
Reimbursement: Incorrect DRG assignment leading to reimbursement issues., Compliance: Potential for audit failure due to misclassification., Data Quality: Inaccurate clinical data affecting patient records.
Mitigation Strategy
Ensure EEG findings and psychological evaluations are documented to differentiate PNES from epilepsy.
Impact
Risk of coding PNES as epilepsy without proper documentation.
Mitigation Strategy
Ensure EEG and psychological evaluations are documented.
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 Pseudoseizure, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Pseudoseizure
Use these documentation templates to ensure complete and accurate documentation for Pseudoseizure. These templates include all required elements for proper coding and billing.
Neurology Consult for PNES
Specialty: NeurologyRequired Elements
- History of Present Illness
- EEG Findings
- Psych Evaluation
- Assessment
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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