ICD Code G40.901

ICD code G40.901 is used to classify a diagnosis of epilepsy that is unspecified and not intractable, meaning it is not resistant to treatment, and is accompanied by status epilepticus, a condition where seizures follow one another without recovery of consciousness between them.

1. Recurrent Seizures: The patient experiences two or more unprovoked seizures, which are not triggered by an immediate identifiable cause.

2. Status Epilepticus: The patient has a prolonged seizure lasting more than five minutes or experiences multiple seizures without regaining full consciousness between them.

3. Unspecified Epilepsy: The specific type of epilepsy is not determined, meaning it does not fit into a more specific category of epilepsy types.

4. Non-Intractable: The seizures are manageable with standard treatment options and do not require specialized or advanced therapeutic interventions.

5. Absence of Identifiable Cause: There is no clear underlying condition or acute precipitating factor identified that could explain the occurrence of seizures.

6. Clinical Evaluation: The diagnosis is supported by clinical evaluation, including patient history, neurological examination, and possibly EEG findings, but without a definitive classification of epilepsy type.

7. Exclusion of Other Conditions: Other potential causes of seizures, such as metabolic disturbances, infections, or acute neurological insults, have been ruled out.

For the ICD code G40.901, the relevant CPT codes that may be applicable for treatment and management include:

1. 99201-99215: Evaluation and Management (E/M) services for new or established patients, which may be used for initial assessment and ongoing management of the condition.

2. 95950: Monitoring for identification and localization of cerebral seizure focus, by computerized analysis of electroencephalographic (EEG) data, with interpretation and report.

3. 95951: Monitoring for localization of cerebral seizure focus by cable or radio, 16 or more channel telemetry, combined electroencephalographic (EEG) and video recording and interpretation (e.g., for presurgical localization).

4. 95953: Monitoring for localization of cerebral seizure focus by cable or radio, 8 or more channel telemetry, electroencephalographic (EEG) recording and interpretation.

5. 95956: Monitoring for localization of cerebral seizure focus by cable or radio, 16 or more channel telemetry, electroencephalographic (EEG) recording and interpretation.

6. 96116: Neurobehavioral status exam (clinical assessment of thinking, reasoning, and judgment, e.g., acquired knowledge, attention, language, memory, planning and problem solving, and visual-spatial abilities), per hour of the psychologist’s or physician’s time, both face-to-face time with the patient and time interpreting test results and preparing the report.

7. 96132: Neuropsychological testing evaluation services by physician or other qualified healthcare professional, including integration of patient data, interpretation of standardized test results and clinical data, clinical decision making, treatment planning, and report, administered by physician or other qualified healthcare professional, first hour.

These CPT codes are examples of procedures and services that may be relevant for the management and treatment of the condition associated with ICD code G40.901. It is important for healthcare providers to select the appropriate CPT codes based on the specific services rendered and the clinical context.

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