R56.9: Unspecified convulsions
R56.9 is a billable, specific ICD-10-CM code for unspecified convulsions. It is valid for submission on a claim.
Check R56.9 with the rest of the claim: free scrubberInclusion terms
Alternative wordings a physician may use in the chart for this same code.
- Convulsion disorder
- Fit NOS
- Recurrent convulsions
- Seizure(s) (convulsive) NOS
Other codes that can never be billed with R56.9
Their own Excludes1 notes name this code, so the conflict is not listed above.
Risk adjustment
R56.9 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
R56.9 is named in 21 Medicare coverage policies: 21 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
- A56612Billing and Coding: CT of the Head
Alphabetic index entries that lead here
- Convulsions(idiopathic)
- Fit
- Seizure(s)
- Convulsions›recurrent
- Disorder›paroxysmal, mixed
Code history
Unchanged in every release from FY2024 to FY2027.