G40.119
BillableLocalization-related (focal) (partial) symptomatic epilepsy and epileptic syndromes with simple partial seizures, intractable, without 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 163 — Seizure Disorders, Intractable Epilepsy
0.000What This Code Means
A type of epilepsy caused by a known brain condition with simple partial seizures that is difficult to control with medication, without current prolonged seizure activity.
Coding Tips
- •The '11' indicates symptomatic with simple partial seizures that are intractable; the final '9' indicates no status epilepticus
- •Document medication trials and failures to support the 'intractable' designation
Clinical Significance
This code captures symptomatic focal epilepsy with simple partial seizures that are drug-resistant (intractable) but without current status epilepticus. These patients have ongoing seizures despite adequate medication trials and may be candidates for surgical evaluation. The symptomatic designation identifies an underlying structural or metabolic cause contributing to the drug resistance.
Documentation Requirements
- ✓Documentation of symptomatic focal epilepsy with identified underlying cause
- ✓Simple partial seizure type documented with preservation of consciousness
- ✓Evidence of intractability: documentation of failed antiepileptic medication trials
- ✓Ongoing seizure frequency despite medication compliance
- ✓Confirmation patient is NOT in status epilepticus
- ✓Documentation of the underlying cause and any surgical candidacy evaluation
Commonly Confused Codes
G40.109 — Same type, NOT intractable; medication responsive versionG40.111 — Same type, intractable, WITH status epilepticus; acute emergency presentationG40.219 — Symptomatic focal with COMPLEX partial seizures, intractable; different seizure typeG40.019 — IDIOPATHIC focal epilepsy, intractable; no identified causeG40.919 — Epilepsy unspecified, intractable; less specific
Code Hierarchy
└G40Epilepsy and recurrent seizures└G40.1Localization-related (focal) (partial) symptomatic epilepsy and epileptic syndromes with simple partial seizures└G40.11Localization-related (focal) (partial) symptomatic epilepsy and epileptic syndromes with simple partial seizures, intractable└G40.119Localization-related (focal) (partial) symptomatic epilepsy and epileptic syndromes with simple partial seizures, intractable, without status epilepticus
└G40.119Localization-related (focal) (partial) symptomatic epilepsy and epileptic syndromes with simple partial seizures, intractable, without status epilepticus