G40.411: Other generalized epilepsy and epileptic syndromes, intractable, with status epilepticus
G40.411 is a billable, specific ICD-10-CM code for other generalized epilepsy and epileptic syndromes, intractable, with status epilepticus. It is valid for submission on a claim.
Check G40.411 with the rest of the claim: free scrubberExcludes1 inherited from the categories above G40.411
A category’s note binds every code beneath it.
Excludes2 inherited from the categories above G40.411
Not part of this code, but both may be coded when both are present.
Other codes that can never be billed with G40.411
Their own Excludes1 notes name this code, so the conflict is not listed above.
Risk adjustment
G40.411 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
G40.411 is named in 30 Medicare coverage policies: 30 listing it as supporting medical necessity. Which one applies depends on your Medicare contractor.
- A53134Billing and Coding: NCD Coding Article for Positron Emission Tomography (PET) Scans Used for Non-Oncologic Conditions
- A54799Billing and Coding: Urine Drug Testing
- A55001Billing and Coding: Urine Drug Testing
- A56551Billing and Coding: Visual Fields Testing
Alphabetic index entries that lead here
- Seizure›grand mal›intractable›with status epilepticus
- Epilepsy, epileptic, epilepsia›generalized›specified NEC›intractable›with status epilepticus
- Epilepsy, epileptic, epilepsia›syndromes›generalized›specified NEC›intractable›with status epilepticus
Code history
Unchanged in every release from FY2024 to FY2027.