Is G40.109 a billable ICD-10-CM code?

Yes. G40.109 is a billable, specific ICD-10-CM code and is valid for submission on a claim.

Where does G40.109 sit in the tabular list?

Diseases of the nervous system (G00-G99), in the block Episodic and paroxysmal disorders (G40-G47).

G40.109

G40.109 — Localization-related (focal) (partial) symptomatic epilepsy and epileptic syndromes with simple partial seizures, not intractable, without status epilepticus

Billable / specific codeICD-10-CM

G40.109 is a billable, specific ICD-10-CM code for localization-related (focal) (partial) symptomatic epilepsy and epileptic syndromes with simple partial seizures, not intractable, without status epilepticus. It is valid for submission on a claim.

Inclusion terms

Alternative wordings a physician may use in the chart for this same code.

Localization-related (focal) (partial) symptomatic epilepsy and epileptic syndromes with simple partial seizures NOS

Risk adjustment

G40.109 risk-adjusts. Under the CMS-HCC V28 model it maps to this category:

HCC 201 Seizure Disorders and Convulsions0.245 RAF

Coefficient shown for the Community Non-dual Aged segment. A higher HCC in the same hierarchy will suppress this one, so capturing it does not always add score.

Medicare coverage

G40.109 is named in 23 Medicare coverage policies — 23 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.

A56551Billing and Coding: Visual Fields Testing
A56612Billing and Coding: CT of the Head
A56619Billing and Coding: Nerve Conduction Studies and Electromyography
A56631Billing and Coding: Thoracic Aortography and Carotid, Vertebral, and Subclavian Angiography

How G40.109 is indexed

Coders do not find codes by browsing the tabular list — they look them up in the alphabetic index, under the word the physician wrote. These are the index entries that lead here, so you can see which chart wordings map to G40.109.

Kozhevnikof's epilepsy
Kozhevnikof's epilepsy›not intractable
Kozhevnikof's epilepsy›not intractable›without status epilepticus
Epilepsy, epileptic, epilepsia›localization-related›symptomatic›with simple partial seizures
Epilepsy, epileptic, epilepsia›localization-related›symptomatic›with simple partial seizures›not intractable
Epilepsy, epileptic, epilepsia›syndromes›localization-related›symptomatic›with simple partial seizures
Epilepsy, epileptic, epilepsia›localization-related›symptomatic›with simple partial seizures›not intractable›without status epilepticus
Epilepsy, epileptic, epilepsia›syndromes›localization-related›symptomatic›with simple partial seizures›not intractable
Epilepsy, epileptic, epilepsia›syndromes›localization-related›symptomatic›with simple partial seizures›not intractable›without status epilepticus

Related codes at this level

Codes that share G40.10. If G40.109 is not quite right, the correct code is usually one of these.

G40.101Localization-related (focal) (partial) symptomatic epilepsy and epileptic syndromes with simple partial seizures, not intractable, with status epilepticus

Questions about G40.109

Is G40.109 a billable ICD-10-CM code?: Yes. G40.109 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
Where does G40.109 sit in the tabular list?: Diseases of the nervous system (G00-G99), in the block Episodic and paroxysmal disorders (G40-G47).