ICD Code G40.109

ICD code G40.109 is localization-related (focal) symptomatic epilepsy with simple partial seizures that are not difficult to control (not intractable) and have not resulted in a prolonged seizure episode (without status epilepticus).

1. Patient presents with recurrent, unprovoked seizures that are focal in onset.

2. Seizures are characterized by simple partial symptoms (e.g., motor, sensory, autonomic, or psychic symptoms) without impairment of consciousness.

3. No evidence of intractability; seizures are controlled with treatment or have not failed adequate trials of antiepileptic medications.

4. No history or current evidence of status epilepticus.

5. Clinical evaluation and diagnostic testing (e.g., EEG, neuroimaging) support a symptomatic etiology for the epilepsy (i.e., attributable to an underlying structural or metabolic condition).

6. Seizure semiology and diagnostic findings are consistent with localization-related (focal) epilepsy.

Relevant CPT codes for ICD code G40.109 may include:

- 95812: Electroencephalogram (EEG) extended monitoring; 41-60 minutes

- 95813: Electroencephalogram (EEG) extended monitoring; greater than 1 hour

- 95951: Monitoring for localization of cerebral seizure focus by computerized portable neurophysiology data analysis (e.g., EEG, EKG, EMG)

- 99202-99215: Evaluation and management (E/M) office or other outpatient visits

- 96116: Neurobehavioral status exam

- 96132, 96133: Neuropsychological testing evaluation services

- 99217-99226: Hospital observation or inpatient care services

CPT code selection should be based on the specific services rendered for ICD code G40.109.

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