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G40.409

G40.409: Other generalized epilepsy and epileptic syndromes, not intractable, without status epilepticus

Billable / specific codeICD-10-CM

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.

Check G40.409 with the rest of the claim: free scrubber

Excludes1 inherited from the categories above G40.409

A category’s note binds every code beneath it.

Written on G40: Epilepsy and recurrent seizures

  • conversion disorder with seizures (F44.5)
  • convulsions NOS (R56.9)
  • post traumatic seizures (R56.1)
  • seizure (convulsive) NOS (R56.9)
  • seizure of newborn (P90)

Excludes2 inherited from the categories above G40.409

Not part of this code, but both may be coded when both are present.

Written on G40: Epilepsy and recurrent seizures

Other codes that can never be billed with G40.409

Their own Excludes1 notes name this code, so the conflict is not listed above.

  • G25.3Myoclonus
  • R56Convulsions, not elsewhere classified
  • R56.1Post traumatic seizures

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. Look up the whole chart to see which of its HCCs the hierarchy would zero.

Medicare coverage

G40.409 is named in 25 Medicare coverage policies: 25 listing it as supporting medical necessity. Which one applies depends on your Medicare contractor.

  • 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

Alphabetic index entries that lead here

  • 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

Code history

Unchanged in every release from FY2024 to FY2027.

Other codes under G40.40

ICD-10-CMFY2027· effective October 1, 2026

Loaded directly from the CMS/NCHS ICD-10-CM public-domain release: see data sources and our editorial policy. If this page disagrees with the CMS tabular list, this page is wrong. Reference information for professional coders; not medical or billing advice.