G40.409 — Other generalized epilepsy and epileptic syndromes, not intractable, without status epilepticus
G40.409 is a billable, specific ICD-10-CM code for other generalized epilepsy and epileptic syndromes, not intractable, without status epilepticus. It is valid for submission on a claim.
Risk adjustment
G40.409 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
G40.409 is named in 28 Medicare coverage policies — 28 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.
- A54799Billing and Coding: Urine Drug Testing
- A55001Billing and Coding: Urine Drug Testing
- A56551Billing and Coding: Visual Fields Testing
- A56612Billing and Coding: CT of the Head
How G40.409 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 G40.409.
- Myoclonus, myoclonic, myoclonia›epileptica
- Seizure›grand mal
- Epilepsy, epileptic, epilepsia›generalized›specified NEC
- Seizure›grand mal›not intractable
- Epilepsy, epileptic, epilepsia›generalized›specified NEC›not intractable
- Epilepsy, epileptic, epilepsia›syndromes›generalized›specified NEC
- Seizure›grand mal›not intractable›without status epilepticus
- Epilepsy, epileptic, epilepsia›generalized›specified NEC›not intractable›without status epilepticus
- Epilepsy, epileptic, epilepsia›syndromes›generalized›specified NEC›not intractable
- Epilepsy, epileptic, epilepsia›syndromes›generalized›specified NEC›not intractable›without status epilepticus
Related codes at this level
Codes that share G40.40. If G40.409 is not quite right, the correct code is usually one of these.
Questions about G40.409
- Is G40.409 a billable ICD-10-CM code?
- Yes. G40.409 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does G40.409 sit in the tabular list?
- Diseases of the nervous system (G00-G99), in the block Episodic and paroxysmal disorders (G40-G47).