G40.804
BillableOther epilepsy, 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 form of epilepsy that doesn't fit other specific categories and cannot be adequately controlled with medication, not currently in a prolonged seizure state.
Coding Tips
- •Document the medications tried and failed to establish intractability
- •Consider noting if the patient is a candidate for surgical intervention or other advanced treatments
Clinical Significance
Other epilepsy, intractable, without status epilepticus identifies patients with drug-resistant epilepsy not classified in specific syndrome categories who are not currently in seizure emergency. These patients have ongoing uncontrolled seizures despite adequate medication trials and may be candidates for advanced therapies such as epilepsy surgery, vagus nerve stimulation, or responsive neurostimulation.
Documentation Requirements
- ✓Documentation of intractable or pharmacoresistant epilepsy
- ✓List of antiepileptic medications tried and failed
- ✓Confirmation status epilepticus is NOT present
- ✓Epilepsy type that does not fit specific syndrome categories
- ✓Current treatment plan including any advanced therapy evaluations
- ✓Seizure frequency and impact on daily functioning
Commonly Confused Codes
G40.802 — Same type, NOT intractable, without status epilepticusG40.803 — Same type, intractable, WITH status epilepticusG40.419 — Other GENERALIZED epilepsy, intractable; use when generalized type is specifiedG40.919 — UNSPECIFIED epilepsy, intractable; less specificG40.814 — Lennox-Gastaut, intractable; use when this syndrome is confirmed
Code Hierarchy
└G40Epilepsy and recurrent seizures└G40.8Other epilepsy and recurrent seizures└G40.80Other epilepsy└G40.804Other epilepsy, intractable, without status epilepticus
└G40.804Other epilepsy, intractable, without status epilepticus