G40.B11
BillableJuvenile myoclonic epilepsy, intractable, with 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
Juvenile myoclonic epilepsy that does not respond adequately to medication treatment, with the patient currently experiencing status epilepticus, which is a serious condition of prolonged or repeated seizures.
Coding Tips
- •Document that seizures are intractable (drug-resistant) and that status epilepticus is present during the encounter
- •Status epilepticus is a medical emergency; ensure appropriate emergency care documentation is included
Clinical Significance
Intractable juvenile myoclonic epilepsy with status epilepticus is an uncommon but serious presentation. While JME typically responds well to appropriate medications, some patients have drug-resistant forms, and status epilepticus in this context is a medical emergency. Treatment-resistant JME may indicate incorrect medication choice (some antiepileptics worsen myoclonic seizures) rather than true pharmacoresistance.
Documentation Requirements
- ✓Confirmed JME diagnosis
- ✓Documentation of intractability with failed medication trials
- ✓Active status epilepticus during the encounter
- ✓Complete medication history including agents tried and failed
- ✓Assessment for medication appropriateness (avoiding seizure-worsening drugs)
- ✓Emergency interventions provided
Commonly Confused Codes
G40.B01 — JME, NOT intractable, with status epilepticusG40.B19 — JME, intractable, WITHOUT status epilepticusG40.C11 — Lafora disease, intractable, with status epilepticus; progressive condition unlike JMEG40.A11 — Absence epilepsy, intractable, with status epilepticusG40.911 — Unspecified epilepsy, intractable, with status epilepticus
Code Hierarchy
└G40Epilepsy and recurrent seizures└G40.BJuvenile myoclonic epilepsy [impulsive petit mal]└G40.B1Juvenile myoclonic epilepsy, intractable└G40.B11Juvenile myoclonic epilepsy, intractable, with status epilepticus
└G40.B11Juvenile myoclonic epilepsy, intractable, with status epilepticus