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G40.821

Billable

Epileptic spasms, not intractable, with status epilepticus

HCC Category Mapping

V28HCC 201Seizure Disorders and Convulsions
0.262
V24HCC 79Seizure Disorders and Convulsions
0.244
ESRDHCC 79Seizure Disorders and Convulsions
0.000
RxHCCHCC 164Seizure Disorders, Non-Intractable Epilepsy
0.000

What This Code Means

Epileptic spasms that can be controlled with medication, currently experiencing a prolonged seizure state (status epilepticus).

Coding Tips

  • Verify documentation confirms both the spasm type and active status epilepticus to justify this specific code
  • Distinguish from G40.822 by confirming the patient is currently in or recently experienced status epilepticus

Clinical Significance

Epileptic spasms (formerly infantile spasms or West syndrome) with status epilepticus represent a severe seizure type characterized by sudden flexion or extension movements, often occurring in clusters. When presenting with status epilepticus, this is a neurological emergency. Epileptic spasms are a hallmark of early-life epileptic encephalopathies and carry significant risk of developmental regression.

Documentation Requirements

  • Documentation of epileptic spasms (flexor, extensor, or mixed type)
  • Active status epilepticus during the encounter
  • Statement that spasms respond to treatment (not intractable)
  • EEG findings (hypsarrhythmia if infantile spasms)
  • Age of onset and developmental assessment
  • Treatment provided including ACTH, vigabatrin, or other first-line agents

Commonly Confused Codes

Code Hierarchy

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