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G40.834

Billable

Dravet syndrome, 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

Dravet syndrome (a severe genetic epilepsy starting in infancy) that does not respond well to medication, not currently in a prolonged seizure state.

Coding Tips

  • Ensure genetic confirmation or clinical diagnosis of Dravet syndrome is documented in the record
  • Document the intractable nature with evidence of failed anti-seizure medication trials

Clinical Significance

Dravet syndrome, intractable, without status epilepticus captures the chronic management phase of this severe genetic epilepsy. Dravet syndrome is almost always intractable, making this the most common Dravet code. These patients require complex multi-drug regimens avoiding sodium channel blockers, and face ongoing risks of SUDEP, cognitive decline, and gait deterioration throughout life.

Documentation Requirements

  • Confirmed Dravet syndrome diagnosis (SCN1A mutation or clinical criteria)
  • Documentation of intractability
  • Absence of status epilepticus at the encounter
  • Current medication regimen avoiding contraindicated sodium channel blockers
  • Seizure diary or frequency documentation
  • Developmental and cognitive assessments
  • SUDEP risk discussion and seizure safety plan

Commonly Confused Codes

Code Hierarchy

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