2025 ICD-10-CM code G40.3
(Active) Effective Date: N/A Episodic and paroxysmal disorders - Epilepsy and recurrent seizures 6 (Diseases of the Nervous System) Feed
Generalized idiopathic epilepsy and epileptic syndromes.Consider also MERRF syndrome (E88.42), if applicable.
Medical necessity for diagnostic testing and treatment is established by the presence of epileptic seizures.The specific tests and treatment modalities used should be justified based on the individual patient's presentation and clinical course.
Diagnosis is typically made by neurologists based on patient history, physical and neurological examination, EEG findings, and neuroimaging (MRI, CT). Genetic testing might be relevant in certain cases. Treatment focuses on managing seizures with anti-epileptic drugs and other therapies like deep brain stimulation or surgery if medication fails.
In simple words: This code represents a type of epilepsy where seizures begin on both sides of the brain at the same time. The cause of these seizures may be genetic or unknown. Seizures may involve jerking or stiffening of muscles, loss of muscle control, brief muscle twitches or staring spells.Additional symptoms can include loss of consciousness, loss of bladder control, and tongue biting.
This code encompasses a range of epileptic disorders characterized by abnormal electrical activity affecting both sides of the brain, typically without identifiable structural brain abnormalities.It often manifests between early childhood and adolescence, and may be genetic or idiopathic (unknown cause). Symptoms include a variety of seizure types, such as clonic (jerking), tonic (rigidity), atonic (loss of muscle tone), myoclonic (brief twitching), and absence seizures.Associated symptoms can involve loss of consciousness, body stiffness, loss of bladder control, and tongue biting.
Example 1: A 10-year-old patient presents with a history of recurrent generalized tonic-clonic seizures.EEG confirms generalized epilepsy, and no structural brain abnormalities are found on MRI.G40.3 is assigned., A young adult experiences absence seizures characterized by brief staring spells.EEG shows generalized spike-and-wave discharges.No other cause is found. G40.3 is assigned., A child has myoclonic seizures with brief, involuntary muscle jerks.After a comprehensive evaluation, including genetic testing ruling out specific syndromes, the diagnosis of juvenile myoclonic epilepsy is made, which is a type of generalized idiopathic epilepsy. G40.3 is applied.
Documentation should include detailed descriptions of seizure types, frequency, duration, and any associated symptoms.EEG reports, neuroimaging findings, and results of genetic testing (if performed) should also be documented.Medical history, family history of seizures, and response to treatment are essential elements.
** It's crucial to differentiate generalized idiopathic epilepsy from other types of epilepsy and seizure disorders with specific etiologies.Always use the most specific code available.If applicable, use additional codes to document the specific epilepsy syndrome and any comorbidities.
- Specialties:Neurology, Pediatric Neurology, Epileptology
- Place of Service:Inpatient Hospital, Outpatient Hospital, Physician's Office