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.
Inclusion terms
Alternative wordings a physician may use in the chart for this same code.
- Convulsion disorder
- Fit NOS
- Recurrent convulsions
- Seizure(s) (convulsive) NOS
Excludes1 inherited from the categories above R56.9
These are not written on R56.9, but they bind it: a note on a category applies to every code beneath it. Billing R56.9 with anything listed here is a denial.
Other codes that can never be billed with R56.9
These codes carry an Excludes1 note pointing at R56.9. The conflict binds both ways, but ICD-10-CM only writes it down on one side — so you would not find this by reading R56.9 alone.
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.
Medicare coverage
R56.9 is named in 22 Medicare coverage policies — 22 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
- A56612Billing and Coding: CT of the Head
How R56.9 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 R56.9.
- Convulsions(idiopathic)
- Fit
- Seizure(s)
- Convulsions›recurrent
- Disorder›paroxysmal, mixed
Code history
R56.9 has not changed since FY2024 — no addition, revision or deletion across the three most recent ICD-10-CM releases.
Related codes at this level
Codes that share R56. If R56.9 is not quite right, the correct code is usually one of these.
Questions about R56.9
- Is R56.9 a billable ICD-10-CM code?
- Yes. R56.9 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does R56.9 sit in the tabular list?
- Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R99), in the block General symptoms and signs (R50-R69).
- What cannot be coded together with R56.9?
- R56.9 carries Excludes1 notes, which means the conditions they list can never be coded together with it on the same encounter. Some are written on the categories above R56.9 (R56) and apply to it just the same.