ICD Code R56.01

ICD code R56.01 is complex febrile convulsions, which refers to seizures in children triggered by fever that are prolonged, occur more than once during a 24-hour period, or have focal features.

1. Occurrence of a seizure associated with fever in a child aged 6 months to 5 years

2. Seizure lasting more than 15 minutes

3. Presence of multiple seizures within a 24-hour period

4. Seizure with focal features (such as movement or twitching limited to one side or one part of the body)

5. No evidence of central nervous system infection or acute metabolic disturbance

6. No prior history of afebrile seizures

Relevant CPT codes that may be used to treat ICD code R56.01 include:

- 99221–99223 (Initial hospital care, per day, for the evaluation and management of a patient)

- 99231–99233 (Subsequent hospital care, per day, for the evaluation and management of a patient)

- 99291 (Critical care, evaluation and management of the critically ill or critically injured patient; first 30-74 minutes)

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

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

- 96372 (Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular)

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

CPT code selection should be based on the specific services rendered and clinical scenario associated with ICD code R56.01.

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