G40 — Epilepsy and recurrent seizures
G40 is a non-billable header ICD-10-CM code for epilepsy and recurrent seizures. It cannot be billed on its own: choose one of the more specific child codes below.
Excludes1 — never code together
These conditions cannot occur together. Billing both on the same encounter is a denial.
Excludes2 — not included here, but may coexist
The excluded condition is not part of this code, but a patient can have both. You may code both.
Notes
Additional guidance from the ICD-10-CM tabular list.
- the following terms are to be considered equivalent to intractable: pharmacoresistant (pharmacologically resistant), treatment resistant, refractory (medically) and poorly controlled
Other codes that can never be billed with G40
These codes carry an Excludes1 note pointing at G40. The conflict binds both ways, but ICD-10-CM only writes it down on one side — so you would not find this by reading G40 alone.
Risk adjustment
G40 does not map to an HCC and does not risk-adjust under CMS-HCC V28. That is normal — most ICD-10 codes do not. It still needs to be coded correctly; it just will not move a RAF score.
Code to one of these instead G40
11 child codes. Green means billable.
- G40.0Localization-related (focal) (partial) idiopathic epilepsy and epileptic syndromes with seizures of localized onset
- G40.1Localization-related (focal) (partial) symptomatic epilepsy and epileptic syndromes with simple partial seizures
- G40.2Localization-related (focal) (partial) symptomatic epilepsy and epileptic syndromes with complex partial seizures
- G40.3Generalized idiopathic epilepsy and epileptic syndromes
- G40.AAbsence epileptic syndrome
- G40.BJuvenile myoclonic epilepsy [impulsive petit mal]
- G40.CLafora progressive myoclonus epilepsy
- G40.4Other generalized epilepsy and epileptic syndromes
- G40.5Epileptic seizures related to external causes
- G40.8Other epilepsy and recurrent seizures
- G40.9Epilepsy, unspecified
Questions about G40
- Is G40 a billable ICD-10-CM code?
- No. G40 is a non-billable header code. Code to a higher level of specificity using one of its child codes.
- Where does G40 sit in the tabular list?
- Diseases of the nervous system (G00-G99), in the block Episodic and paroxysmal disorders (G40-G47).
- What cannot be coded together with G40?
- G40 carries an Excludes1 note, which means the conditions it lists can never be coded together with it on the same encounter.