2025 ICD-10-CM code R56.00
(Active) Effective Date: N/A Revision Date: N/A Deletion Date: N/A Symptoms, signs, and abnormal clinical and laboratory findings - General symptoms and signs Chapter 18: Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R99) Feed
Simple febrile convulsions; also known as febrile convulsion NOS or febrile seizure NOS.
Medical necessity for coding R56.00 is established by the presence of a seizure directly related to a fever.The physician's documentation should clearly link the seizure to the fever, and rule out other possible etiologies of the seizure. The medical necessity may be further supported by the need for immediate medical attention, monitoring, and management of the seizure and the underlying fever.
The clinical responsibility for this code involves the physician's assessment of the patient's symptoms, including the history of fever and the characteristics of the seizure. This assessment should include a thorough neurological examination and the documentation of vital signs, such as temperature and heart rate. Investigations to rule out other causes are typically needed.The physician might order laboratory tests, brain imaging, or an EEG.
- Chapter 18: Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R99)
- R56.00 is under the broader category of R56 (Febrile convulsions) which falls within the larger chapter of symptoms, signs, and abnormal clinical findings (R00-R99).
In simple words: This code describes a seizure caused by a fever, usually in children between 6 months and 5 years old.During the seizure, the child's muscles might shake uncontrollably, and they may lose awareness.Their skin may become pale or bluish.
R56.00, Simple febrile convulsions, is an ICD-10-CM code that classifies febrile seizures that are not otherwise specified (NOS).Febrile seizures are convulsions triggered by a fever, typically occurring in children aged 6 months to 5 years.The seizure involves involuntary muscle contractions and altered consciousness.The patient may exhibit pallor or cyanosis.This code is used when a more specific diagnosis cannot be established, even after investigation.It's crucial to note that this code excludes dissociative convulsions and seizures, epileptic convulsions and seizures, and newborn convulsions and seizures.
Example 1: A 2-year-old child presents to the emergency room with a high fever and a generalized tonic-clonic seizure lasting approximately 2 minutes.The child is afebrile on arrival at the hospital and has no neurological deficits post-seizure.Code R56.00 would be used to represent the febrile seizure., A 1-year-old child is brought to the pediatrician's office with a history of fever and a brief seizure lasting less than 15 seconds. The child is alert and without neurological symptoms.After investigation, no other cause is determined.Code R56.00 would be appropriate for the febrile seizure., A 4-year-old child experiences a brief, generalized seizure that lasts only a few seconds during a period of high fever. The child’s parents reported a history of similar incidents with preceding high temperatures. No other symptoms or neurological abnormalities are observed, and the child resumes normal activity quickly. Code R56.00 is used to classify this event.
Detailed documentation is crucial, including the patient's age, history of fever, seizure duration, type of seizure (generalized or focal), associated symptoms, and neurological examination findings before and after the seizure.Any laboratory tests, brain imaging, or EEG results should also be documented.Temperature readings at various times are essential for accurate coding.
** Accurate coding of R56.00 requires careful clinical judgment and detailed documentation to distinguish simple febrile convulsions from other types of seizures.This code is specifically for simple febrile convulsions where no other underlying condition is identified.
- Payment Status: Active
- Specialties:Pediatrics, Neurology, Emergency Medicine
- Place of Service:Office, Emergency Room - Hospital, Inpatient Hospital