G40.101
BillableLocalization-related (focal) (partial) symptomatic epilepsy and epileptic syndromes with simple partial seizures, not intractable, with status epilepticus
HCC Category Mapping
V28HCC 201 — Seizure Disorders and Convulsions
0.262V24HCC 79 — Seizure Disorders and Convulsions
0.244ESRDHCC 79 — Seizure Disorders and Convulsions
0.000RxHCCHCC 164 — Seizure Disorders, Non-Intractable Epilepsy
0.000What This Code Means
A type of epilepsy caused by a known brain condition with simple partial seizures (affecting one area of the brain) that responds to medication, and the patient is currently experiencing prolonged seizure activity.
Coding Tips
- •The '10' indicates symptomatic (known cause) with simple partial seizures; the final '1' indicates status epilepticus is present
- •Document the underlying cause of the epilepsy (e.g., brain injury, stroke, tumor) to support medical necessity
Clinical Significance
This code captures symptomatic focal epilepsy with simple partial seizures (consciousness preserved) that is medication-responsive but with current status epilepticus. The 'symptomatic' designation means there is an identifiable cause (brain injury, stroke, tumor). Status epilepticus in this context is a medical emergency requiring immediate treatment.
Documentation Requirements
- ✓Documentation of focal epilepsy with identified structural or metabolic cause
- ✓Documentation that seizures are simple partial (consciousness preserved during seizures)
- ✓Active status epilepticus with onset time and emergency treatment
- ✓Identification of the underlying cause (prior stroke, brain tumor, traumatic brain injury, etc.)
- ✓Statement that the epilepsy is generally not intractable (medication responsive)
- ✓EEG findings and neuroimaging documenting the structural lesion
Commonly Confused Codes
G40.001 — Idiopathic focal epilepsy with status epilepticus; no identified cause vs. symptomaticG40.109 — Same type WITHOUT status epilepticus; the stable baseline versionG40.201 — Symptomatic focal epilepsy with COMPLEX partial seizures and status epilepticus; impaired consciousnessG40.111 — Same type, intractable, with status epilepticus; drug-resistant versionG40.301 — Generalized idiopathic epilepsy with status epilepticus; generalized onset
Code Hierarchy
└G40Epilepsy and recurrent seizures└G40.1Localization-related (focal) (partial) symptomatic epilepsy and epileptic syndromes with simple partial seizures└G40.10Localization-related (focal) (partial) symptomatic epilepsy and epileptic syndromes with simple partial seizures, not intractable└G40.101Localization-related (focal) (partial) symptomatic epilepsy and epileptic syndromes with simple partial seizures, not intractable, with status epilepticus
└G40.101Localization-related (focal) (partial) symptomatic epilepsy and epileptic syndromes with simple partial seizures, not intractable, with status epilepticus