ICD Code G40.409

ICD code G40.409 is other generalized epilepsy and epileptic syndromes that are not intractable and do not involve status epilepticus.

1. Patient presents with generalized epileptic seizures.

2. Seizures are not classified under specific generalized epilepsy syndromes.

3. Seizures are not intractable (respond to treatment or are controlled).

4. No evidence or documentation of status epilepticus.

5. Clinical evaluation and diagnostic testing (such as EEG) support a diagnosis of generalized epilepsy.

6. Exclusion of focal (partial) epilepsy or epileptic syndromes.

7. No identification of a more specific generalized epilepsy syndrome (e.g., juvenile myoclonic epilepsy, childhood absence epilepsy).

Relevant CPT codes that may be used to treat ICD code G40.409 include:

- 95816 (Electroencephalogram [EEG]; including recording awake and drowsy)

- 95819 (Electroencephalogram [EEG]; including recording awake and asleep)

- 95951 (Monitoring for localization of cerebral seizure focus by cable or radio; 16 or more channel telemetry, attended by a technologist)

- 99202–99215 (Evaluation and management services, new or established patient office visits)

- 96372 (Therapeutic, prophylactic, or diagnostic injection [specify substance or drug]; subcutaneous or intramuscular)

- 96365 (Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour)

- 99406–99407 (Smoking and tobacco use cessation counseling visit)

- 99408–99409 (Alcohol and/or substance abuse structured screening and brief intervention services)

- J8499 (Prescription drug, oral, non-chemotherapeutic, NOS – for oral antiepileptic medications)

CPT code selection should be based on the specific services rendered for ICD code G40.409.

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