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G40.824

Billable

Epileptic spasms, intractable, without 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, 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

Code Hierarchy

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