ICD Code G40.309

ICD code G40.309 is used to classify a type of epilepsy that is generalized and idiopathic, meaning its cause is unknown. This code specifies that the epilepsy is not intractable, indicating that it can be controlled with treatment, and it does not involve status epilepticus, which is a condition where seizures follow one another without recovery of consciousness between them.

1. Recurrent Seizures: The patient experiences multiple episodes of seizures that are generalized, meaning they affect both sides of the brain from the onset.

2. Idiopathic Nature: There is no identifiable cause for the epilepsy, such as a structural brain lesion or a metabolic disorder, indicating it is idiopathic.

3. Non-Intractable: The seizures are responsive to treatment, meaning they can be controlled or managed effectively with medication or other therapeutic interventions.

4. Absence of Status Epilepticus: The patient does not experience prolonged seizures or repeated seizures without recovery in between, which would constitute status epilepticus.

5. Clinical Evaluation: A thorough clinical evaluation, including patient history and neurological examination, supports the diagnosis of generalized idiopathic epilepsy.

6. Electroencephalogram (EEG) Findings: EEG results may show generalized spike-and-wave or polyspike-and-wave discharges, consistent with generalized epilepsy.

7. Exclusion of Other Conditions: Other potential causes of seizures, such as focal epilepsy, metabolic disturbances, or acute symptomatic seizures, have been ruled out.

8. Age of Onset: Typically, the onset of symptoms occurs in childhood or adolescence, although it can vary.

9. Family History: There may be a family history of epilepsy or seizure disorders, supporting the idiopathic nature of the condition.

10. Normal Neurological Function: The patient generally maintains normal neurological function and development outside of seizure episodes.

For the ICD code G40.309, the relevant CPT codes that may be applicable include:

1. CPT 95812 - Electroencephalogram (EEG) extended monitoring; 41-60 minutes.

2. CPT 95813 - Electroencephalogram (EEG) extended monitoring; greater than 1 hour.

3. CPT 95816 - Electroencephalogram (EEG); including recording awake and drowsy.

4. CPT 95819 - Electroencephalogram (EEG); including recording awake and asleep.

5. CPT 95950 - Ambulatory EEG monitoring; 24-hour analysis.

6. CPT 95951 - Monitoring for localization of cerebral seizure focus by cable or radio; electroencephalographic (EEG) and video recording, each 24 hours.

7. CPT 95953 - Monitoring for localization of cerebral seizure focus by cable or radio; electroencephalographic (EEG) recording only, each 24 hours.

8. CPT 99201-99215 - Evaluation and management services, depending on the complexity and time spent with the patient.

These CPT codes are commonly used in the diagnosis and management of conditions associated with the ICD code G40.309. It is important to verify the specific services provided and ensure accurate coding based on the procedures performed.

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