ICD-10-CM 2026 · Effective October 1, 2025

ICD-10 G40

Non-Billable Header

Epilepsy and recurrent seizures

G40
Block
0
Synonyms
0
LCDs
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Payer Policies
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Linked CPTs

About ICD-10-CM G40

ICD-10-CM code G40 represents Epilepsy and recurrent seizures. This is a non-billable header code in the Nervous System chapter (block G40). The 2026 edition of ICD-10-CM G40 became effective on October 1, 2025. Non-billable codes cannot be used as a primary or secondary diagnosis on a claim, use a more specific child code instead.

Type 1 Excludes

Pure excludes, these codes can never be coded together with G40. The conditions are mutually exclusive (e.g., congenital vs acquired forms).

  • conversion disorder with seizures (F44.5)
  • convulsions NOS (R56.9)
  • post traumatic seizures (R56.1)
  • seizure (convulsive) NOS (R56.9)
  • seizure of newborn (P90)

Type 2 Excludes

Not included here, the excluded code is not part of G40, but a patient may have both conditions at the same time. Both codes may be coded together when applicable.

  • hippocampal sclerosis (G93.81)
  • mesial temporal sclerosis (G93.81)
  • temporal sclerosis (G93.81)
  • Todd's paralysis (G83.84)

Medicare LCD Coverage for G40

Local Coverage Determinations (LCDs) from CMS MACs that list G40 as a covered diagnosis.

No Medicare LCDs reference G40 as covered

This doesn't mean the code isn't covered, it means no MAC has issued a Local Coverage Determination naming this specific code. Coverage may still apply under National Coverage Determinations or general medical-necessity rules.

Commercial Payer Coverage

Coverage policies from major commercial payers referencing G40.

No commercial payer policies reference G40 on file

Our payer policy database covers Aetna, Cigna, Anthem, BCBS, Humana, and Medicare Advantage plans, but G40 doesn't currently appear in any indexed policy. The code may still be covered under standard plan benefits.

CPT Codes Commonly Billed with G40

Procedures frequently paired with this diagnosis based on PayerReady's Dx↔Px linkage data.

No procedure linkages on file for G40

We don't have CPT pairings indexed for this specific code yet. Use the CPT search above to find common procedures, or check your payer's published medical policy for code-specific guidance.

Codes Adjacent To G40

Other codes in section G40-G47 (Episodic and paroxysmal disorders).

G40.0 Localization-related (focal) (partial) idiopathic epilepsy and epileptic syndromes with seizures of localized onset (non-billable) G40.00 Localization-related (focal) (partial) idiopathic epilepsy and epileptic syndromes with seizures of localized onset, not intractable (non-billable) G40.001 Localization-related (focal) (partial) idiopathic epilepsy and epileptic syndromes with seizures of localized onset, not intractable, with status epilepticus G40.009 Localization-related (focal) (partial) idiopathic epilepsy and epileptic syndromes with seizures of localized onset, not intractable, without status epilepticus G40.01 Localization-related (focal) (partial) idiopathic epilepsy and epileptic syndromes with seizures of localized onset, intractable (non-billable) G40.011 Localization-related (focal) (partial) idiopathic epilepsy and epileptic syndromes with seizures of localized onset, intractable, with status epilepticus G40.019 Localization-related (focal) (partial) idiopathic epilepsy and epileptic syndromes with seizures of localized onset, intractable, without status epilepticus G40.1 Localization-related (focal) (partial) symptomatic epilepsy and epileptic syndromes with simple partial seizures (non-billable) G40.10 Localization-related (focal) (partial) symptomatic epilepsy and epileptic syndromes with simple partial seizures, not intractable (non-billable) G40.101 Localization-related (focal) (partial) symptomatic epilepsy and epileptic syndromes with simple partial seizures, not intractable, with status epilepticus G40.109 Localization-related (focal) (partial) symptomatic epilepsy and epileptic syndromes with simple partial seizures, not intractable, without status epilepticus G40.11 Localization-related (focal) (partial) symptomatic epilepsy and epileptic syndromes with simple partial seizures, intractable (non-billable) G40.111 Localization-related (focal) (partial) symptomatic epilepsy and epileptic syndromes with simple partial seizures, intractable, with status epilepticus G40.119 Localization-related (focal) (partial) symptomatic epilepsy and epileptic syndromes with simple partial seizures, intractable, without status epilepticus G40.2 Localization-related (focal) (partial) symptomatic epilepsy and epileptic syndromes with complex partial seizures (non-billable) G40.20 Localization-related (focal) (partial) symptomatic epilepsy and epileptic syndromes with complex partial seizures, not intractable (non-billable) G40.201 Localization-related (focal) (partial) symptomatic epilepsy and epileptic syndromes with complex partial seizures, not intractable, with status epilepticus G40.209 Localization-related (focal) (partial) symptomatic epilepsy and epileptic syndromes with complex partial seizures, not intractable, without status epilepticus G40.21 Localization-related (focal) (partial) symptomatic epilepsy and epileptic syndromes with complex partial seizures, intractable (non-billable) G40.211 Localization-related (focal) (partial) symptomatic epilepsy and epileptic syndromes with complex partial seizures, intractable, with status epilepticus

ICD-10 G40, Billing FAQ

Is ICD-10 code G40 billable? +

No, G40 is a non-billable header code. Use a more specific child code from block G40 when submitting claims.

What codes are Type 1 Excludes for G40? +

Type 1 Excludes (never code together with G40): conversion disorder with seizures (F44.5); convulsions NOS (R56.9); post traumatic seizures (R56.1)

What codes are Type 2 Excludes for G40? +

Type 2 Excludes (may be coded together when both conditions exist): hippocampal sclerosis (G93.81); mesial temporal sclerosis (G93.81); temporal sclerosis (G93.81)

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Reviewed by the PayerReady Medical Coding Team

Verified against the CMS 2026 code set on June 1, 2026.

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