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G40

Non-Billable (Header)

Epilepsy and recurrent seizures

Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)

What This Code Means

G40 is the ICD-10-CM diagnosis code for epilepsy and recurrent seizures. G40 sits in the ICD-10-CM chapter for diseases of the nervous system (g00-g99), within the section covering episodic and paroxysmal disorders (g40-g47).

Header codes like G40 cannot be reported on claims directly — they organize child codes that share clinical context but the actual diagnosis must be coded to the highest level of specificity supported by the documentation. Coders should look at G40's child codes and select the one that matches the patient's documented presentation, since payers reject header codes submitted as the primary diagnosis. For risk adjustment workflows, header codes never contribute to a Medicare Advantage member's RAF score on their own; only billable child codes that happen to map to a payment HCC affect risk-adjusted plan payments.

HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for G40 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Excludes 1 — Do NOT code together

  • conversion disorder with seizures (F44.5)
  • convulsions NOS (R56.9)
  • post traumatic seizures (R56.1)
  • seizure (convulsive) NOS (R56.9)
  • seizure of newborn (P90)

Excludes 2 — Not included here, may code separately

Child Codes

Code Hierarchy

G40Epilepsy and recurrent seizures
G40Epilepsy and recurrent seizures

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