G40.311
BillableGeneralized idiopathic epilepsy and epileptic syndromes, 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 163 — Seizure Disorders, Intractable Epilepsy
0.000What This Code Means
A generalized epilepsy that affects the entire brain from the start and is difficult to control with medication, and the patient is currently experiencing status epilepticus.
Coding Tips
- •The '1' in the fifth character indicates status epilepticus, which is a medical emergency requiring intensive care
- •Clearly document failed medication trials to support the intractable diagnosis in the medical record
Clinical Significance
This code captures the most severe form of generalized idiopathic epilepsy — drug-resistant and in active status epilepticus. It represents a neurological emergency with the highest morbidity and mortality risk among the generalized epilepsy codes. These patients require ICU-level care and may need aggressive interventions including anesthetic infusions to terminate seizures.
Documentation Requirements
- ✓Documentation of generalized idiopathic epilepsy (bilateral onset, no identified cause)
- ✓Evidence of intractable status with documented medication failure history
- ✓Active status epilepticus with onset time, type, duration, and emergency interventions
- ✓Documentation of failed antiepileptic medications (at least 2 adequate trials)
- ✓EEG monitoring documentation for ongoing seizure activity assessment
- ✓ICU admission and treatment escalation documentation
Commonly Confused Codes
G40.319 — Same type, intractable, WITHOUT status epilepticus; non-emergency intractable stateG40.301 — Same type, NOT intractable, WITH status epilepticus; breakthrough eventG40.011 — FOCAL idiopathic epilepsy, intractable, with status epilepticus; focal onsetG40.311 vs. G40.411 — Idiopathic vs. other specified generalized epilepsy; different etiology classificationG40.309 — Same type, not intractable, without status epilepticus; stable controlled state
Code Hierarchy
└G40Epilepsy and recurrent seizures└G40.3Generalized idiopathic epilepsy and epileptic syndromes└G40.31Generalized idiopathic epilepsy and epileptic syndromes, intractable└G40.311Generalized idiopathic epilepsy and epileptic syndromes, intractable, with status epilepticus
└G40.311Generalized idiopathic epilepsy and epileptic syndromes, intractable, with status epilepticus