G40.824
BillableEpileptic spasms, 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
Epileptic spasms that do not respond well to medication, not currently in a prolonged seizure state.
Coding Tips
- •Document evidence of drug-resistant epilepsy (failed medication trials) to justify the intractable designation
- •Confirm absence of status epilepticus in current documentation
Clinical Significance
Intractable epileptic spasms without status epilepticus is a common presentation in drug-resistant infantile spasms or ongoing epileptic spasm disorder. These patients have failed standard treatments and continue to have spasms that impact development. Many are evaluated for epilepsy surgery, particularly when a focal lesion like tuberous sclerosis is identified.
Documentation Requirements
- ✓Documentation of epileptic spasms diagnosis
- ✓Evidence of intractability with failed medication trials
- ✓Absence of status epilepticus at the encounter
- ✓Complete treatment history including ACTH, vigabatrin, and other agents tried
- ✓Surgical evaluation results if applicable
- ✓Developmental and cognitive assessment
- ✓Underlying etiology if identified
Commonly Confused Codes
G40.822 — Epileptic spasms, NOT intractable, without status epilepticusG40.823 — Epileptic spasms, intractable, WITH status epilepticusG40.814 — Lennox-Gastaut, intractable; may evolve from spasmsG40.804 — Other epilepsy, intractable; less specificG40.42 — CDKL5 Deficiency Disorder; use when CDKL5 mutation is confirmed
Code Hierarchy
└G40Epilepsy and recurrent seizures└G40.8Other epilepsy and recurrent seizures└G40.82Epileptic spasms└G40.824Epileptic spasms, intractable, without status epilepticus
└G40.824Epileptic spasms, intractable, without status epilepticus