G40.823
BillableEpileptic spasms, 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 163 — Seizure Disorders, Intractable Epilepsy
0.000What 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
G40.821 — Epileptic spasms with status epilepticus but NOT intractableG40.824 — Epileptic spasms, intractable, WITHOUT status epilepticusG40.813 — Lennox-Gastaut, intractable, with status epilepticus; distinct syndromeG40.833 — Dravet syndrome, intractable, with status epilepticus; genetic epilepsyG40.803 — Other epilepsy, intractable, with status epilepticus; less specific
Code Hierarchy
└G40Epilepsy and recurrent seizures└G40.8Other epilepsy and recurrent seizures└G40.82Epileptic spasms└G40.823Epileptic spasms, intractable, with status epilepticus
└G40.823Epileptic spasms, intractable, with status epilepticus