Skip to content
HCC Buddy home

G40.834 ICD-10-CM Code: Dravet syndrome, intractable, without status epilepticus

G40.834 maps to CMS-HCC V28 201. A source-labeled RAF reference is available. Confirm the documented diagnosis and applicable coding requirements. MEAT criteria · RAF Calculator · HCC coding software

ICD-10-CM Code View

HCC Buddy Code Card

Digital ICD-10 code-book layout with official code detail, always-visible risk models, Code Trumping, and Buddy coding guidance.

Code lookupG40.834

FY 2026 Apr update / Diseases of the nervous system (G00-G99) / Episodic and paroxysmal disorders (G40-G47)

G40.834

Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidance

Dravet syndrome, intractable, without status epilepticus

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

Buddy the Bee presenting code insight

Buddy Insight

Dravet syndrome, intractable, without status epilepticus captures the chronic management phase of this severe genetic epilepsy.

OverviewRisk ModelsCode BookDocumentationAuditNotesEdition comparison

CMS-HCC V28

HCC 201

Code-level coefficient reference

CMS-HCC V24

Historical

Historical

Not used for CY2026 payment

ACA/HHS

HCC 120

Code-level coefficient reference

ESRD/PACE

HCC 79

Code-level coefficient reference

RXHCC

HCC 163

Code-level coefficient reference

Code Book Path

Official
G40.8Other epilepsy and recurrent seizuresG40.83Dravet syndromeG40.834Dravet syndrome, intractable, without status epilepticus

Inclusion Terms

Official
  • Dravet syndrome NOS
  • Epilepsies and epileptic syndromes undetermined as to whether they are focal or generalizedInherited from G40.8, G40.83
  • Landau-Kleffner syndromeInherited from G40.8, G40.83
  • Polymorphic epilepsy in infancy (PMEI)Inherited from G40.8, G40.83
  • Severe myoclonic epilepsy in infancy (SMEI)Inherited from G40.8, G40.83

Excludes 2

Official
  • certain conditions originating in the perinatal period (P04-P96)Inherited from G00-G99, G40
  • certain infectious and parasitic diseases (A00-B99)Inherited from G00-G99, G40
  • complications of pregnancy, childbirth and the puerperium (O00-O9A)Inherited from G00-G99, G40
  • congenital malformations, deformations, and chromosomal abnormalities (Q00-Q99)Inherited from G00-G99, G40
  • endocrine, nutritional and metabolic diseases (E00-E88)Inherited from G00-G99, G40
  • injury, poisoning and certain other consequences of external causes (S00-T88)Inherited from G00-G99, G40
  • neoplasms (C00-D49)Inherited from G00-G99, G40
  • symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R94)Inherited from G00-G99, G40
  • hippocampal sclerosis (G93.81)Inherited from G00-G99, G40
  • mesial temporal sclerosis (G93.81)Inherited from G00-G99, G40
  • temporal sclerosis (G93.81)Inherited from G00-G99, G40
  • Todd's paralysis (G83.84)Inherited from G00-G99, G40

Related Codes

Official
G40.833Dravet syndrome, intractable, with status epilepticus

Includes

Official

No Includes notes are included in this display for G40.834. Check the code and parent instructions in the Code Book.

Excludes 1

Official
  • conversion disorder with seizures (F44.5)Inherited from G40
  • convulsions NOS (R56.9)Inherited from G40
  • post traumatic seizures (R56.1)Inherited from G40
  • seizure (convulsive) NOS (R56.9)Inherited from G40
  • seizure of newborn (P90)Inherited from G40

Code First

Official

No Code First sequencing instructions are included in this display for G40.834. Check the code and parent instructions in the Code Book.

Use Additional

Official

No Use Additional Code instructions are included in this display for G40.834. Check the code and parent instructions in the Code Book.

Code Also

Official

No Code Also instructions are included in this display for G40.834. Check the code and parent instructions in the Code Book.

Buddy Documentation Tip

HCC Buddy guidance
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

MEAT Support

HCC Buddy guidance
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

Audit Caution

HCC Buddy guidance
Not using the Dravet-specific code when the diagnosis is confirmed in the record
Failing to separately code comorbid conditions (intellectual disability, gait abnormalities, behavioral issues)
Using non-intractable codes for Dravet — this syndrome is nearly always drug-resistant
Missing the opportunity to code genetic status for counseling and research purposes

Common Mistakes

HCC Buddy guidance
G40.833 — Dravet, intractable, WITH status epilepticus
G40.814 — Lennox-Gastaut, intractable; different epileptic encephalopathy
G40.804 — Other epilepsy, intractable; use when Dravet is not confirmed
G40.824 — Epileptic spasms, intractable; different seizure type

Current with CMS: FY2026 ICD-10-CM Apr 1 update (effective Apr 1 – Sep 30, 2026) · CMS-HCC V28, 100% phased in for payment year 2026. FY2027 code set already staged for October 1, 2026. How HCC Buddy stays current →

Is G40.834 an HCC code?

Yes. G40.834 (Dravet syndrome, intractable, without status epilepticus) maps to HCC 201, Seizure Disorders and Convulsions under the CMS-HCC V28 risk adjustment model, with a source-labeled community non-dual aged reference coefficient of 0.245. Source-labeled code-level coefficients are references, not member totals. Actual contribution depends on complete member context, hierarchy and cleanup rules, interactions, and model year. HCC Buddy's RAF Calculator supports CMS-HCC V28 PY2026 and shows no score unless every required source and calculation check passes. It is billable for payment year 2026.

Coder answer: G40.834 is billable and maps to V28 HCC 201, Seizure Disorders and Convulsions. Open it in the Code Book for the tabular path, RAF, and MEAT checklist.

Code
G40.834
Description
Dravet syndrome, intractable, without status epilepticus
HCC (V28)
HCC 201 — Seizure Disorders and Convulsions
RAF reference coefficient
0.245
Billable
Yes
Payment year
2026

HCC Category Mapping

V28HCC 201, Seizure Disorders and Convulsions
0.245
ESRDHCC 79, Seizure Disorders and Convulsions
Not separately weighted
RxHCCHCC 163, Intractable Epilepsy
Not separately weighted

These are source-labeled model coefficients, not member totals. A category may still be removed by hierarchy or model cleanup rules. Weights are not directly comparable across models: CMS-HCC V28 and V24 use Community, Non-Dual, Aged; ESRD uses the dialysis continuing-enrollee model; RxHCC is the Part D continuing-enrollee, non-low-income, aged weight (a larger scale than CMS-HCC). ACA/HHS has no single weight — it varies by metal level. Actual per-patient RAF contribution depends on member context, hierarchy and cleanup rules, interactions, and the model year used by the payer. V28 is the CMS-HCC model phased in over payment years 2024–2026; V24 remains available for historical review.

Work G40.834 in the Code Book — tabular path, V28 RAF reference, and MEAT checklist →

MEAT review for G40.834

For G40.834, confirm that the documentation supports the diagnosis and meets the applicable coding, encounter, program and payer requirements. MEAT (Monitor, Evaluate, Assess, or Treat) is a review mnemonic, not a universal CMS coding rule.

  • MMonitor: signs, symptoms, disease progression, or lab trending documented in the note
  • EEvaluate: test results, medication response, or physical findings reviewed by the provider
  • AAssess: explicit mention in the assessment or plan with acknowledgment of status
  • TTreat: medication, referral, procedure, therapy, or counseling tied to the diagnosis

Coder workflow notes

Get the V28 mapping + MEAT cheat sheet

One printable reference: check representative V28 mappings and the documentation reminders your note needs. Free, no card.

Free PDF. No card. Unsubscribe anytime.

What This Code Means

G40.834 is the ICD-10-CM diagnosis code for dravet syndrome, intractable, without status epilepticus. Dravet syndrome (a severe genetic epilepsy starting in infancy) that does not respond well to medication, not currently in a prolonged seizure state. G40.834 sits in the ICD-10-CM chapter for diseases of the nervous system (g00-g99), within the section covering episodic and paroxysmal disorders (g40-g47).

Under the CMS-HCC V28 risk adjustment model, G40.834 maps to Seizure Disorders and Convulsions (HCC 201) with a source-labeled community, non-dual, aged reference coefficient of 0.245. No V24 mapping is shown for G40.834; use the applicable model and payment year when reviewing the V28 mapping. For CY2026 non-PACE Medicare Advantage, CMS uses 100% of the 2024 CMS-HCC model (V28). PACE uses a separate model blend. Source-labeled code-level coefficients are references, not member totals. Actual contribution depends on complete member context, hierarchy and cleanup rules, interactions, and model year. HCC Buddy's RAF Calculator supports CMS-HCC V28 PY2026 and shows no score unless every required source and calculation check passes.

Ensure genetic confirmation or clinical diagnosis of Dravet syndrome is documented in the record. For G40.834, confirm that the documentation supports the diagnosis and meets the applicable coding, encounter, program and payer requirements. MEAT (Monitor, Evaluate, Assess, or Treat) is a review mnemonic, not a universal CMS coding rule. When documentation is ambiguous, coders should issue a provider query rather than assume the highest-specificity variant.

HCC Buddy maintains structured V28 and V24 mapping, source-labeled coefficient references, and MEAT documentation criteria for G40.834 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

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

  • •G40.833: Dravet, intractable, WITH status epilepticus
  • •G40.814: Lennox-Gastaut, intractable; different epileptic encephalopathy
  • •G40.804: Other epilepsy, intractable; use when Dravet is not confirmed
  • •G40.824: Epileptic spasms, intractable; different seizure type
  • •G40.419: Other generalized epilepsy, intractable; less specific

Child Codes

G40.833Dravet syndrome, intractable, with status epilepticus
HCC 201
G40.834Dravet syndrome, intractable, without status epilepticus
HCC 201

Code Hierarchy

└G40Epilepsy and recurrent seizures└G40.8Other epilepsy and recurrent seizures└G40.83Dravet syndrome└G40.834Dravet syndrome, intractable, without status epilepticus
└G40.834Dravet syndrome, intractable, without status epilepticus

G40.834 code history

Code setChange
FY2021 (effective Oct 1, 2020)Added to the code set

Source: official CMS ICD-10-CM order and addenda files, FY2016 through FY2027.

For G40.834, confirm that the documentation supports the diagnosis and meets the applicable coding, encounter, program and payer requirements. MEAT (Monitor, Evaluate, Assess, or Treat) is a review mnemonic, not a universal CMS coding rule.

G40.834 maps to CMS-HCC V28 category 201, Seizure Disorders and Convulsions. See the ICD-10 to HCC mapping hub for how the V28 crosswalk works. The mapping identifies a payment HCC category for G40.834. Review its source-labeled HCC coefficient above, check the RAF Calculator with complete member context for CMS-HCC V28 PY2026, and confirm the documentation the chart needs before the code is submitted. HCC Buddy shows no RAF score unless every required source and calculation check passes.

Work G40.834 in HCC Buddy

Open G40.834 in the Code Book for the full Index-to-Tabular path, MEAT checklist, and V28 HCC mapping, or in the Encoder to code from a keyword search. Pro includes 7 days to try everything, no card required.

Open in Code BookOpen in EncoderStart Pro