G93.45 — Developmental and epileptic encephalopathy
G93.45 is a billable, specific ICD-10-CM code for developmental and epileptic encephalopathy. It is valid for submission on a claim.
Code also
Both codes may be needed to describe the encounter fully. Sequencing depends on the reason for the visit.
- , if applicable, associated disorders such as:
- developmental disorders of scholastic skills (F81.-)
- developmental disorder of speech and language (F80.-)
- epilepsy, by specific type (G40.-)
- intellectual disabilities (F70-F79)
- other neurodevelopmental disorder (F88)
- pervasive developmental disorders (F84.-)
Inclusion terms
Alternative wordings a physician may use in the chart for this same code.
- Early infantile epileptic encephalopathy
Risk adjustment
G93.45 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
G93.45 is named in 6 Medicare coverage policies — 5 listing it as supporting medical necessity, and 1 listing it as NOT covered. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.
- A56562Billing and Coding: Health and Behavior Assessment/Interventionnot covered
- A56612Billing and Coding: CT of the Head
- A56619Billing and Coding: Nerve Conduction Studies and Electromyography
- A56771Billing and Coding: Special Electroencephalography
How G93.45 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 G93.45.
- Encephalopathy›developmental and epileptic
- Encephalopathy›early infantile epileptic
Related codes at this level
Codes that share G93.4. If G93.45 is not quite right, the correct code is usually one of these.
Questions about G93.45
- Is G93.45 a billable ICD-10-CM code?
- Yes. G93.45 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does G93.45 sit in the tabular list?
- Diseases of the nervous system (G00-G99), in the block Other disorders of the nervous system (G89-G99).