R56.01

Billable

Complex febrile convulsions

HCC Category Mapping

V28HCC 201 — Seizure Disorders and Convulsions

0.262

V24HCC 79 — Seizure Disorders and Convulsions

0.244

ESRDHCC 79 — Seizure Disorders and Convulsions

0.000

What This Code Means

Seizures that occur with fever in children, characterized by multiple seizure episodes or prolonged seizure activity lasting more than 15 minutes.

Coding Tips

•Document the duration and number of seizure episodes to distinguish complex from simple febrile convulsions
•Ensure the fever is documented and linked to the convulsion; code the underlying cause of fever separately if known

Clinical Significance

Complex febrile convulsions are prolonged or recurrent seizures associated with fever that carry higher risk for future epilepsy and neurological complications. These episodes require more intensive evaluation and follow-up compared to simple febrile seizures due to increased risk of subsequent seizure disorders and potential neurological sequelae.

Documentation Requirements

✓Documentation of prolonged seizure (>15 minutes) with fever
✓Multiple seizures within 24 hours, or focal features
✓Age of child documented
✓Temperature during episode
✓Duration and characteristics of seizure
✓Neurological examination findings
✓EEG results if performed
✓Investigation for serious bacterial infection

Excludes 1 — Do NOT code together

status epilepticus (G40.901)

Commonly Confused Codes

R56.00 — Simple febrile convulsions lack complex features G40.9 — Epilepsy when seizures occur without fever R56.1 — Post-traumatic seizures have different etiology R56.9 — Unspecified when complex features documented

Code Hierarchy

└R56Convulsions, not elsewhere classified └R56.0Febrile convulsions └R56.01Complex febrile convulsions

└R56.01Complex febrile convulsions