G40.919
BillableEpilepsy, unspecified, 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
Epilepsy of unknown type that is resistant to medication, without current status epilepticus.
Coding Tips
- •Document failed medication trials to justify the 'intractable' designation
- •Distinguish between intractable epilepsy (drug-resistant) and uncontrolled seizures due to non-compliance
Clinical Significance
Unspecified epilepsy, intractable, without status epilepticus identifies patients with drug-resistant seizures of undetermined epilepsy type who are not in acute crisis. These patients have ongoing uncontrolled seizures despite medication and would benefit from comprehensive evaluation to determine epilepsy syndrome for targeted treatment approaches.
Documentation Requirements
- ✓Documentation of intractable/drug-resistant epilepsy
- ✓List of medications tried and failed
- ✓Absence of status epilepticus at the encounter
- ✓Current seizure frequency and impact on functioning
- ✓Referral or plan for comprehensive epilepsy evaluation
- ✓Current medication regimen
Commonly Confused Codes
G40.909 — Unspecified epilepsy, NOT intractable; seizures controlledG40.911 — Unspecified epilepsy, intractable, WITH status epilepticusG40.804 — Other epilepsy, intractable; slightly more specificG40.419 — Other generalized epilepsy, intractable; use when type is knownG40.814 — Lennox-Gastaut, intractable; use when syndrome is confirmed
Code Hierarchy
└G40Epilepsy and recurrent seizures└G40.9Epilepsy, unspecified└G40.91Epilepsy, unspecified, intractable└G40.919Epilepsy, unspecified, intractable, without status epilepticus
└G40.919Epilepsy, unspecified, intractable, without status epilepticus