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G40.823

Billable

Epileptic spasms, 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 163Seizure Disorders, Intractable Epilepsy
0.000

What This Code Means

Epileptic spasms that do not respond well to medication, currently experiencing a prolonged seizure state (status epilepticus).

Coding Tips

  • Confirm documentation shows failed trials of multiple anti-seizure medications to support 'intractable' status
  • Ensure status epilepticus is explicitly documented as present during the encounter

Clinical Significance

Intractable epileptic spasms with status epilepticus represents one of the most severe pediatric epilepsy presentations. Drug-resistant spasms in status epilepticus carry high risk of brain injury, developmental regression, and mortality. These patients often require aggressive treatment including high-dose ACTH, combination therapy, and may be urgent surgical candidates.

Documentation Requirements

  • Documentation of epileptic spasms with intractability (failed medication trials)
  • Active status epilepticus during the encounter
  • List of medications attempted and failed (ACTH, vigabatrin, etc.)
  • Emergency interventions and ICU management
  • Etiology workup results (genetic, structural, metabolic)
  • Surgical evaluation documentation if applicable

Commonly Confused Codes

Code Hierarchy

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