2025 ICD-10-CM code G40
(Valid) Effective Date: N/A Diseases of the nervous system - Epilepsy and recurrent seizures 6 Feed
Epilepsy and recurrent seizures.Conditions such as pharmacoresistant, pharmacologically resistant, treatment resistant, medically refractory, and poorly controlled are considered equivalent to intractable.
Medical necessity for services related to epilepsy should be supported by documentation of the diagnosis, seizure frequency and severity, impact on daily life, and treatment plan.
Not every patient with seizures has epilepsy; it is diagnosed only when a patient has multiple seizure episodes. Clinicians should determine the specific type of epilepsy, whether it's intractable, and the presence of status epilepticus.
In simple words: Epilepsy is a brain disorder that causes repeated seizures. Seizures happen when nerve cells in the brain send out the wrong signals. This can cause a person to have strange sensations, emotions, or behavior. They may have muscle spasms or lose consciousness.Epilepsy can be caused by many things, such as illness, brain injury, or abnormal brain development. Sometimes the cause is unknown. Doctors use tests like brain scans to diagnose epilepsy. Treatment with medicine or surgery can often control seizures.
Epilepsy and recurrent seizures are characterized by abnormal electrical activity in the brain, leading to recurring seizures. These seizures manifest as various symptoms, including convulsions, changes in awareness or consciousness, and unusual sensations or behaviors. Epilepsy can be classified as partial (affecting one part of the brain) or generalized (involving the whole brain or multiple areas). The cause can be attributed to factors like injury, infection, brain tumors, genetics, or may be unknown (idiopathic). Diagnosis involves evaluating medical history, symptoms, physical and neurological examinations, EEG, MRI, CT scans, and genetic testing.
Example 1: A 25-year-old patient presents with a history of multiple unprovoked seizures, confirmed by EEG and MRI. They experience loss of consciousness and convulsions during seizures. Diagnosis: G40 (Epilepsy and recurrent seizures)., A 10-year-old child experiences recurrent episodes of staring spells and unusual sensations. Neurological evaluation and EEG findings suggest focal seizures. Diagnosis: G40 (Epilepsy and recurrent seizures)., A 40-year-old patient with a history of head trauma experiences repeated seizures. Imaging studies reveal a brain lesion. Diagnosis: G40 (Epilepsy and recurrent seizures).
Documentation should include the type of seizures, frequency, duration, associated symptoms (e.g., loss of consciousness, convulsions), and any triggers or warning signs. Diagnostic test results (EEG, MRI, CT scan) and details of medical history, including any prior head injuries or illnesses, should also be documented. If the epilepsy is intractable, documentation should support this with treatment resistance or lack of response to medications.
- Specialties:Neurology, Pediatrics, Emergency Medicine
- Place of Service:Inpatient Hospital, On Campus-Outpatient Hospital, Off Campus-Outpatient Hospital, Office, Home, Skilled Nursing Facility, Nursing Facility