G40.821
BillableEpileptic spasms, not 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 164 — Seizure Disorders, Non-Intractable Epilepsy
0.000What 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
G40.822 — Epileptic spasms, not intractable, WITHOUT status epilepticusG40.823 — Epileptic spasms, INTRACTABLE, with status epilepticusG40.811 — Lennox-Gastaut with status epilepticus; LGS may evolve from spasms but is distinctG40.42 — CDKL5 Deficiency Disorder; may present with spasms but has specific genetic codeR25.8 — Other abnormal involuntary movements; non-epileptic movement disorders
Code Hierarchy
└G40Epilepsy and recurrent seizures└G40.8Other epilepsy and recurrent seizures└G40.82Epileptic spasms└G40.821Epileptic spasms, not intractable, with status epilepticus
└G40.821Epileptic spasms, not intractable, with status epilepticus