2025 ICD-10-CM code G40.80
(Valid) Effective Date: N/A Diseases of the nervous system - Epilepsy and recurrent seizures 6 Feed
Other specified epilepsy not elsewhere classified.
Medical necessity for services related to G40.80 is established by the presence of epilepsy not otherwise specified, requiring diagnostic evaluation, treatment, and management to control seizures and improve the patient's quality of life.
Diagnosis and management of other specified epilepsy requires a comprehensive neurological evaluation, including a detailed medical history, physical and neurological examination, EEG studies, and possibly neuroimaging (MRI or CT). Treatment focuses on seizure control with anti-epileptic medications, along with supportive therapies as needed, such as speech and language therapy for Landau-Kleffner syndrome.
In simple words: This code is used when a person has epilepsy, a brain disorder that causes seizures, but their specific type isn't focal (one side of the brain) or generalized (both sides), and no other specific code fits their condition. It covers less common types like Landau-Kleffner syndrome, where children have seizures and language problems.
This code encompasses epilepsy syndromes that are not defined as focal or generalized and are not represented by another specific ICD-10-CM code.Examples include Landau-Kleffner syndrome and other unclassified epileptic disorders.
Example 1: A 5-year-old child presents with severe language regression, auditory verbal agnosia, and seizures during sleep. EEG shows characteristic abnormalities.The diagnosis of Landau-Kleffner syndrome is made, and G40.80 is used., A patient experiences seizures that are neither clearly focal nor generalized, based on clinical presentation and EEG findings. After extensive workup, no specific epilepsy syndrome is identified. G40.80 is applied to represent this unclassified epilepsy., An adult patient with a history of seizures undergoes comprehensive evaluation, but the seizures do not fit the criteria for any specific epilepsy syndrome. The seizures are not clearly focal or generalized. G40.80 is the appropriate code for this scenario.
Documentation should include detailed clinical findings of the seizure type, frequency, duration, and associated symptoms. EEG findings and results of other diagnostic tests (e.g., MRI, genetic testing) should be recorded. The absence of characteristics defining focal or generalized epilepsy or other specific epilepsy syndromes should be clearly noted.
- Payment Status: Active
- Specialties:Neurology, Pediatric Neurology, Epileptology
- Place of Service:Office, Inpatient Hospital, Outpatient Hospital