G40.211

HCC Category Mapping

What This Code Means

A type of epilepsy that starts in one area of the brain and causes complex partial seizures that are difficult to control with medication, and the patient is currently experiencing status epilepticus (prolonged or repeated seizures).

Coding Tips

• •Status epilepticus (the '1' in the fifth character) indicates a medical emergency requiring immediate documentation and treatment
• •Verify that the seizures are confirmed as intractable (drug-resistant) before coding, as this affects treatment planning and prognosis

Clinical Significance

This code represents a medical emergency — symptomatic focal epilepsy with complex partial seizures that is drug-resistant and the patient is in active status epilepticus. The combination of intractable seizures and status epilepticus with impaired consciousness represents one of the most critical scenarios in epilepsy management, often requiring ICU-level care.

Documentation Requirements

• ✓Documentation of symptomatic focal epilepsy with a known underlying cause
• ✓Complex partial seizure type documented (impaired consciousness)
• ✓Evidence of intractability with documented medication failure history
• ✓Active status epilepticus with onset time, duration, and emergency interventions
• ✓EEG monitoring documentation if nonconvulsive status is suspected
• ✓ICU admission documentation and treatment escalation plan
• ✓Underlying etiology coded separately

Commonly Confused Codes