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G40.411 ICD-10-CM Code: Other generalized epilepsy and epileptic syndromes, intractable, with status epilepticus

Billing Status: YES. This is a valid, specific, and billable ICD-10-CM reference.

Inpatient Payment Groups (MS-DRG)

MS-DRGs this diagnosis helps define, as principal or secondary, per the CMS ICD-10-CM/PCS MS-DRG Definitions Manual v43.0, Appendix B.

  • MS-DRG 023 — CRANIOTOMY WITH MAJOR DEVICE IMPLANT OR ACUTE COMPLEX CNS PRINCIPAL DIAGNOSIS WITH MCC OR ANTINEOPLASTIC IMPLANT OR EPILEPSY WITH NEUROSTIMULATOR (MDC 01)
  • MS-DRG 100 — SEIZURES WITH MCC (MDC 01)
  • MS-DRG 101 — SEIZURES WITHOUT MCC (MDC 01)

A diagnosis appearing in a group's logic does not by itself determine the DRG assigned to a stay; the grouper uses the full claim.

Risk Adjustment (CMS-HCC)

Payment categories this diagnosis maps to under CMS-HCC V28, payment year 2026.

  • HCC 201 — Seizure Disorders and Convulsions

Other models: CMS-HCC V22 HCC 79 · RxHCC V08 HCC 163

Risk scores depend on the enrollee's full accepted diagnosis set and segment; a category mapping alone does not determine payment.

Official Registry Overview & Definition

Other generalized epilepsy and epileptic syndromes, intractable, with status epilepticus is a billable ICD-10-CM diagnosis code (G40.411).

Official Tabular Instructional Notes

Sequencing, inclusion, and exclusion notes published for G40.411 in the official ICD-10-CM tabular list.

Excludes1 — Not Coded Here

Conditions generally not reported together with this code (Excludes1) -- an error unless the two conditions are documented as unrelated to each other (ICD-10-CM Official Guidelines, Section I.A.12.a).

Excludes2 — Not Included Here

Conditions not covered by this code, but which may be reported alongside it when both are present.

Indexed Clinical Terms (3)

Clinical term phrases from the official ICD-10-CM Index to Diseases and Injuries that map to this code.

  • Epilepsy, epileptic, epilepsia (attack) (cerebral) (convulsion) (fit) (seizure), generalized, specified NEC, intractable, with status epilepticus
  • Epilepsy, epileptic, epilepsia (attack) (cerebral) (convulsion) (fit) (seizure), syndromes, generalized, specified NEC, intractable, with status epilepticus
  • Seizure (s), grand mal, intractable, with status epilepticus

Frequently Compared Codes

The official Excludes notes on G40.411 name these codes. Each comparison page covers when the two can — or must not — be reported together.

Change history

No changes recorded for this code — unchanged since the FY2016 baseline of the change ledger.

Verify Before Coding

  • CC as a secondary diagnosis (FY2026). Can raise the stay's MS-DRG severity tier.

From the code registry, the Medicare Code Editor, and the MS-DRG Definitions Manual. Check it against a full claim.

Relationships & Classification

Official ICD-10-CM tabular notes on other codes that name G40.411 or its code family.

3 Excludes1 notes across 2 chapters: G25.3 (via G40.-), R56 (via G40.-), R56.1 (via G40.-).

3 Excludes2 notes across 2 chapters: F44.0 (via G40.-), F44.1 (via G40.-), R25.2 (via G40.4.-).

1 Code First instructions: F02 (via G40.-).

2 Use Additional Code instructions: Q87.87 (via G40.-), Q93.52 (via G40.-).

9 Code Also instructions across 7 chapters: E20.810 (via G40.-), F78.A1 (via G40.-), G04.8 (via G40.-), G43.1 (via G40.-), G93.45 (via G40.-), I67.850 (via G40.-), Q87.85 (via G40.-), QA0 (via G40.-), Z15.1 (via G40.-).

Potential MS-DRG Relationships (FY2026)

CC — Complication or Comorbidity. Reported as a secondary diagnosis, this code raises the stay's MS-DRG severity tier — except when the principal diagnosis is one of 89 clinically related codes on its CMS exclusion list.

Named in the grouper logic of 3 MS-DRGs: DRG 023 (MDC 01), DRG 100 (MDC 01), DRG 101 (MDC 01).

From the CMS MS-DRG Definitions Manual (Appendices B and C). Actual DRG assignment depends on the complete claim.

Clinical classification (AHRQ CCSR):NVS009 — Epilepsy; convulsions (default).

Clinical Classifications Software Refined (CCSR) for ICD-10-CM Diagnoses. Healthcare Cost and Utilization Project (HCUP), Agency for Healthcare Research and Quality.

Contextual Map

Every relationship of G40.411 in one view: hierarchy, official tabular instructions in both directions, clinical classification, risk adjustment, MS-DRG participation, index terms and change history — each edge carrying the CMS source it derives from.

Hierarchy

  • G00-G99 — Chapter 6: Diseases of the Nervous System (G00-G99) (G00-G99) [Hierarchy]
  • G40-G47 — Episodic and paroxysmal disorders [Hierarchy]

Referenced by Excludes1 notes

  • G25.3 — Myoclonus [Excludes1](via G40.-): “myoclonic epilepsy (G40.-)” · check together
  • R56 — Convulsions, not elsewhere classified [Excludes1](via G40.-): “epileptic convulsions and seizures (G40.-)” · check together
  • R56.1 — Post traumatic seizures [Excludes1](via G40.-): “post traumatic epilepsy (G40.-)” · check together

Referenced by Excludes2 notes

  • F44.0 — Dissociative amnesia [Excludes2](via G40.-): “postictal amnesia in epilepsy (G40.-)” · check together
  • F44.1 — Dissociative fugue [Excludes2](via G40.-): “postictal fugue in epilepsy (G40.-)” · check together
  • R25.2 — Cramp and spasm [Excludes2](via G40.4.-): “infantile spasms (G40.4-)” · check together

Referenced by Code First instructions

  • F02 — Dementia in other diseases classified elsewhere [Code First](via G40.-): “epilepsy and recurrent seizures (G40.-)” · check together

Referenced by Use Additional Code instructions

  • Q87.87 — Hao-Fountain Syndrome [Use Additional Code](via G40.-): “epilepsy, by specific type (G40.-)” · check together
  • Q93.52 — Phelan-McDermid syndrome [Use Additional Code](via G40.-): “epilepsy and recurrent seizures (G40.-)” · check together

Referenced by Code Also instructions (9)

  • E20.810 — Autosomal dominant hypocalcemia [Code Also](via G40.-): “seizure disorder (G40.-, R56.9)” · check together
  • F78.A1 — SYNGAP1-related intellectual disability [Code Also](via G40.-): “epilepsy and recurrent seizures (G40.-)” · check together
  • G04.8 — Other encephalitis, myelitis and encephalomyelitis [Code Also](via G40.-): “any associated seizure (G40.-, R56.9)” · check together
  • G43.1 — Migraine with aura [Code Also](via G40.-): “any associated seizure (G40.-, R56.9)” · check together
  • G93.45 — Developmental and epileptic encephalopathy [Code Also](via G40.-): “epilepsy, by specific type (G40.-)” · check together
  • I67.850 — Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy [Code Also](via G40.-): “epilepsy (G40.-)” · check together
  • Q87.85 — MED13L syndrome [Code Also](via G40.-): “epilepsy and recurrent seizures (G40.-)” · check together
  • QA0 — Neurodevelopmental disorders related to specific genetic pathogenic variants [Code Also](via G40.-): “epilepsy, by specific type (G40.-)” · check together
  • and 1 more

Clinical classification (CCSR)

  • NVS009 — Epilepsy; convulsions [CCSR]

Risk adjustment (CMS-HCC)

  • HCC 201 — Seizure Disorders and Convulsions [CMS-HCC]

Potential MS-DRG

  • CC — Complication or Comorbidity [MS-DRG severity]: “As a secondary diagnosis this code can raise the stay's MS-DRG severity tier (CC).”
  • DRG 023 — CRANIOTOMY WITH MAJOR DEVICE IMPLANT OR ACUTE COMPLEX CNS PRINCIPAL DIAGNOSIS WITH MCC OR ANTINEOPLASTIC IMPLANT OR EPILEPSY WITH NEUROSTIMULATOR [MS-DRG]: “CRANIOTOMY WITH MAJOR DEVICE IMPLANT OR ACUTE COMPLEX CNS PRINCIPAL DIAGNOSIS WITH MCC OR ANTINEOPLASTIC IMPLANT OR EPILEPSY WITH NEUROSTIMULATOR (MDC 01)”
  • DRG 100 — SEIZURES WITH MCC [MS-DRG]: “SEIZURES WITH MCC (MDC 01)”
  • DRG 101 — SEIZURES WITHOUT MCC [MS-DRG]: “SEIZURES WITHOUT MCC (MDC 01)”

MDC crossing · procedures (8892)

  • MDC 01 — Diseases and Disorders of the Nervous System [MDC crossing]: “Diseases and Disorders of the Nervous System — the grouper's crossing between diagnoses and procedures: a principal diagnosis sets the MDC, and same-MDC procedures move the stay to its surgical DRGs.”
  • 0016070 — Bypass Cerebral Ventricle to Nasopharynx with Autologous Tissue Substitute, Open Approach [Same-MDC procedure]: “Bypass Cerebral Ventricle to Nasopharynx with Autologous Tissue Substitute, Open Approach — grouped in MDC 01, the procedure side of this code's crossing.” · check together
  • 0016071 — Bypass Cerebral Ventricle to Mastoid Sinus with Autologous Tissue Substitute, Open Approach [Same-MDC procedure]: “Bypass Cerebral Ventricle to Mastoid Sinus with Autologous Tissue Substitute, Open Approach — grouped in MDC 01, the procedure side of this code's crossing.” · check together
  • 0016072 — Bypass Cerebral Ventricle to Atrium with Autologous Tissue Substitute, Open Approach [Same-MDC procedure]: “Bypass Cerebral Ventricle to Atrium with Autologous Tissue Substitute, Open Approach — grouped in MDC 01, the procedure side of this code's crossing.” · check together
  • 0016073 — Bypass Cerebral Ventricle to Blood Vessel with Autologous Tissue Substitute, Open Approach [Same-MDC procedure]: “Bypass Cerebral Ventricle to Blood Vessel with Autologous Tissue Substitute, Open Approach — grouped in MDC 01, the procedure side of this code's crossing.” · check together
  • 0016074 — Bypass Cerebral Ventricle to Pleural Cavity with Autologous Tissue Substitute, Open Approach [Same-MDC procedure]: “Bypass Cerebral Ventricle to Pleural Cavity with Autologous Tissue Substitute, Open Approach — grouped in MDC 01, the procedure side of this code's crossing.” · check together
  • and 8887 more

Index entries

  • Epilepsy, epileptic, epilepsia (attack) (cerebral) (convulsion) (fit) (seizure), generalized, specified NEC, intractable, with status epilepticus[Index term]
  • Epilepsy, epileptic, epilepsia (attack) (cerebral) (convulsion) (fit) (seizure), syndromes, generalized, specified NEC, intractable, with status epilepticus[Index term]
  • Seizure (s), grand mal, intractable, with status epilepticus[Index term]

Nearest codes (40)

  • G40 — Epilepsy and recurrent seizures [Sibling]
  • G40.119 — Localization-related (focal) (partial) symptomatic epilepsy and epileptic syndromes with simple partial seizures, intractable, without status epilepticus [Sibling]
  • G40.2 — Localization-related (focal) (partial) symptomatic epilepsy and epileptic syndromes with complex partial seizures [Sibling]
  • G40.20 — Localization-related (focal) (partial) symptomatic epilepsy and epileptic syndromes with complex partial seizures, not intractable [Sibling]
  • G40.201 — Localization-related (focal) (partial) symptomatic epilepsy and epileptic syndromes with complex partial seizures, not intractable, with status epilepticus [Sibling]
  • G40.209 — Localization-related (focal) (partial) symptomatic epilepsy and epileptic syndromes with complex partial seizures, not intractable, without status epilepticus [Sibling]
  • G40.21 — Localization-related (focal) (partial) symptomatic epilepsy and epileptic syndromes with complex partial seizures, intractable [Sibling]
  • G40.211 — Localization-related (focal) (partial) symptomatic epilepsy and epileptic syndromes with complex partial seizures, intractable, with status epilepticus [Sibling]
  • and 32 more

Nearest Codes in This Family

Official ICD-10-CM classifications closest to G40.411 in its code family, with their registry titles.

  • G40.4 — Other generalized epilepsy and epileptic syndromes
  • G40.40 — Other generalized epilepsy and epileptic syndromes, not intractable
  • G40.401 — Other generalized epilepsy and epileptic syndromes, not intractable, with status epilepticus
  • G40.409 — Other generalized epilepsy and epileptic syndromes, not intractable, without status epilepticus
  • G40.41 — Other generalized epilepsy and epileptic syndromes, intractable
  • G40.419 — Other generalized epilepsy and epileptic syndromes, intractable, without status epilepticus
  • G40.42 — Cyclin-Dependent Kinase-Like 5 Deficiency Disorder
  • G40.5 — Epileptic seizures related to external causes
  • G40.50 — Epileptic seizures related to external causes, not intractable
  • G40.501 — Epileptic seizures related to external causes, not intractable, with status epilepticus

View all codes in the G40 family