G40.911 — Epilepsy, unspecified, intractable, with status epilepticus
G40.911 is a billable, specific ICD-10-CM code for epilepsy, unspecified, intractable, with status epilepticus. It is valid for submission on a claim.
Risk adjustment
G40.911 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
G40.911 is named in 25 Medicare coverage policies — 25 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.
- 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
How G40.911 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 G40.911.
- Epilepsy, epileptic, epilepsia›intractable›with status epilepticus
- Seizure›intractable›with status epilepticus
- Disorder›seizure›intractable›with status epilepticus
Related codes at this level
Codes that share G40.91. If G40.911 is not quite right, the correct code is usually one of these.
Questions about G40.911
- Is G40.911 a billable ICD-10-CM code?
- Yes. G40.911 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does G40.911 sit in the tabular list?
- Diseases of the nervous system (G00-G99), in the block Episodic and paroxysmal disorders (G40-G47).