R56.01: Complex febrile convulsions
R56.01 is a billable, specific ICD-10-CM code for complex febrile convulsions. It is valid for submission on a claim.
Check R56.01 with the rest of the claim: free scrubberExcludes1: never code together
These conditions cannot occur together. Billing both on the same encounter is a denial.
- status epilepticus (G40.901)
Inclusion terms
Alternative wordings a physician may use in the chart for this same code.
- Atypical febrile seizure
- Complex febrile seizure
- Complicated febrile seizure
Risk adjustment
R56.01 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
R56.01 is named in 7 Medicare coverage policies: 7 listing it as supporting medical necessity. Which one applies depends on your Medicare contractor.
- A56612Billing and Coding: CT of the Head
- A56645Billing and Coding: Controlled Substance Monitoring and Drugs of Abuse Testing
- A57189Billing and Coding: Serum Magnesium
- A57204Billing and Coding: MRI and CT Scans of the Head and Neck
Alphabetic index entries that lead here
- Convulsions›febrile›complex
- Seizure›febrile›complex(atypical) (complicated)
Code history
Unchanged in every release from FY2024 to FY2027.