G93.45
BillableDevelopmental and epileptic encephalopathy
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 164 — Seizure Disorders, Non-Intractable Epilepsy
0.000What This Code Means
A severe brain disorder that begins in childhood or infancy, characterized by developmental delays and frequent seizures.
Coding Tips
- •Document the age of onset and the specific genetic mutation if identified through testing
- •This code encompasses multiple genetic forms of developmental and epileptic encephalopathy
Clinical Significance
Developmental and epileptic encephalopathy encompasses a group of severe epilepsy syndromes where epileptic activity itself contributes to progressive cognitive and behavioral deterioration beyond what the underlying brain pathology alone would cause. These conditions typically present in infancy or childhood with refractory seizures and developmental regression. They represent some of the most treatment-resistant and resource-intensive epilepsy conditions.
Documentation Requirements
- ✓Electroencephalography findings documenting epileptiform activity consistent with epileptic encephalopathy
- ✓Documentation of developmental regression or plateau temporally associated with seizure onset
- ✓Specific syndrome identified when possible (e.g., West syndrome, Lennox-Gastaut, Dravet syndrome)
- ✓Genetic testing results if performed (SCN1A, CDKL5, STXBP1, and others)
- ✓Current antiepileptic drug regimen and treatment response documentation
- ✓Developmental assessment documenting cognitive and functional impact
Code Also
- , if applicable, associated disorders such as:
- developmental disorders of scholastic skills (F81.-)
- developmental disorder of speech and language (F80.-)
- epilepsy, by specific type (G40.-)
- intellectual disabilities (F70-F79)
- other neurodevelopmental disorder (F88)
- pervasive developmental disorders (F84.-)
Commonly Confused Codes
G40.A09 — Absence epileptic syndrome, not intractable: less severe epilepsy syndrome without encephalopathyG40.80 — Other epilepsy: simpler epilepsy without the developmental/encephalopathic componentG40.42 — Cyclical vomiting in epilepsy: specific epilepsy manifestation without encephalopathyF84.0 — Autistic disorder: may coexist but represents a developmental disorder without the epileptic encephalopathy component
Code Hierarchy
└G93Other disorders of brain└G93.4Other and unspecified encephalopathy└G93.45Developmental and epileptic encephalopathy
└G93.45Developmental and epileptic encephalopathy