G40.209: Localization-related (focal) (partial) symptomatic epilepsy and epileptic syndromes with complex partial seizures, not intractable, without status epilepticus
G40.209 is a billable, specific ICD-10-CM code for localization-related (focal) (partial) symptomatic epilepsy and epileptic syndromes with complex partial seizures, not intractable, without status epilepticus. It is valid for submission on a claim.
Check G40.209 with the rest of the claim: free scrubberInclusion terms
Alternative wordings a physician may use in the chart for this same code.
- Localization-related (focal) (partial) symptomatic epilepsy and epileptic syndromes with complex partial seizures NOS
Excludes1 inherited from the categories above G40.209
A category’s note binds every code beneath it.
Excludes2 inherited from the categories above G40.209
Not part of this code, but both may be coded when both are present.
Other codes that can never be billed with G40.209
Their own Excludes1 notes name this code, so the conflict is not listed above.
Risk adjustment
G40.209 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. Look up the whole chart to see which of its HCCs the hierarchy would zero.
Medicare coverage
G40.209 is named in 20 Medicare coverage policies: 20 listing it as supporting medical necessity. Which one applies depends on your Medicare contractor.
- 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
Alphabetic index entries that lead here
- Epilepsy, epileptic, epilepsia›localization-related›symptomatic›with complex partial seizures
- Epilepsy, epileptic, epilepsia›localization-related›symptomatic›with complex partial seizures›not intractable
- Epilepsy, epileptic, epilepsia›syndromes›localization-related›symptomatic›with complex partial seizures
- Epilepsy, epileptic, epilepsia›localization-related›symptomatic›with complex partial seizures›not intractable›without status epilepticus
- Epilepsy, epileptic, epilepsia›syndromes›localization-related›symptomatic›with complex partial seizures›not intractable
- Epilepsy, epileptic, epilepsia›syndromes›localization-related›symptomatic›with complex partial seizures›not intractable›without status epilepticus
Code history
Unchanged in every release from FY2024 to FY2027.