G40.419
BillableOther generalized epilepsy and epileptic syndromes, 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 generalized epilepsy of a type other than idiopathic that is difficult to control with medication, and the patient is not currently in status epilepticus.
Coding Tips
- •Document the specific etiology of the secondary generalized epilepsy to provide complete clinical context
- •Note all failed medication trials and any surgical or device-based interventions being considered
Clinical Significance
Intractable other generalized epilepsy without status epilepticus identifies patients with drug-resistant generalized seizures who are not currently in a seizure emergency. These patients have failed adequate trials of antiepileptic medications and typically require complex multi-drug regimens, specialist referrals, and may be evaluated for surgical or device-based interventions. This represents a high-complexity chronic condition with substantial ongoing healthcare needs.
Documentation Requirements
- ✓Explicit documentation that epilepsy is intractable, drug-resistant, or pharmacoresistant
- ✓List of antiepileptic drugs tried and failed (minimum two adequate trials)
- ✓Confirmation that status epilepticus is NOT present at the encounter
- ✓Specific type of generalized epilepsy and etiology
- ✓Current medication regimen and management plan
- ✓Documentation of any advanced treatment considerations (surgery, VNS, responsive neurostimulation)
Commonly Confused Codes
G40.409 — Same epilepsy type WITHOUT intractability; seizures are medication-responsiveG40.411 — Same epilepsy type, intractable, but WITH status epilepticusG40.319 — Generalized IDIOPATHIC epilepsy, intractable, without status epilepticusG40.804 — Other epilepsy, intractable, without status epilepticus; less specific classificationG40.919 — UNSPECIFIED epilepsy, intractable; avoid when generalized type is documented
Code Hierarchy
└G40Epilepsy and recurrent seizures└G40.4Other generalized epilepsy and epileptic syndromes└G40.41Other generalized epilepsy and epileptic syndromes, intractable└G40.419Other generalized epilepsy and epileptic syndromes, intractable, without status epilepticus
└G40.419Other generalized epilepsy and epileptic syndromes, intractable, without status epilepticus