G40.201

HCC Category Mapping

What This Code Means

A type of epilepsy caused by a known brain condition with complex partial seizures (affecting multiple brain areas) that responds to medication, and the patient is currently experiencing prolonged seizure activity.

Coding Tips

• •The '20' indicates symptomatic with complex partial seizures; the final '1' indicates status epilepticus is present
• •Complex partial seizures may involve loss of consciousness or automatisms; ensure seizure type is clearly documented

Clinical Significance

This code captures symptomatic focal epilepsy with complex partial seizures (impaired consciousness during seizures) that is medication-responsive but with current status epilepticus. Complex partial seizures are more disabling than simple partial seizures because the patient loses awareness. Status epilepticus with complex partial seizures (nonconvulsive status) can be subtle and difficult to diagnose without EEG.

Documentation Requirements

• ✓Documentation of symptomatic focal epilepsy with a known underlying cause
• ✓Complex partial seizure type documented — impaired consciousness or awareness during seizures
• ✓Active status epilepticus documented (may be nonconvulsive status requiring EEG confirmation)
• ✓Statement that the epilepsy is generally not intractable (medication responsive)
• ✓Underlying etiology documented (stroke, tumor, cortical malformation, etc.)
• ✓Emergency treatment documentation and monitoring plan

Commonly Confused Codes