Neurosurgery Coding Alert

Question: Encounter notes indicate that a patient suffers from epilepsy that is not intractable with grand mal seizures on awakening. How many diagnosis codes do I need for this patient, and which ones?

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Answer: You’ll actually only need a single diagnosis code for this patient — but you’ll need some more information in order to choose the correct code.

Do this: Go back and check the notes to see if there is an indication of status epilepticus. Then choose from the following diagnosis codes:

• G40.401 (Other generalized epilepsy and epileptic syndromes, not intractable, with status epilepticus)
• G40.409 (Other generalized epilepsy and epileptic syndromes, not intractable, without status epilepticus)

Alternate terms alert: There is a litany of alternate terms beneath the G40.4- (Other generalized epilepsy and epileptic syndromes) descriptor, first among them “Epilepsy with grand mal seizures on awakening.” Per ICD-10, the other epileptic conditions you should report with a G40.4- code are:

• Epilepsy with myoclonic absences
• Epilepsy with myoclonic-astatic seizures
• Grand mal seizure NOS
• Nonspecific atonic epileptic seizures
• Nonspecific clonic epileptic seizures
• Nonspecific myoclonic epileptic seizures
• Nonspecific tonic epileptic seizures
• Nonspecific tonic-clonic epileptic seizures
• Symptomatic early myoclonic encephalopathy.