Health Information Management

Coding for seizures during National Epilepsy Awareness Month

Coding Educator, November 1, 2008

by Shannon McCall, RHIA, CCS, CCS-P, CPC-I
 
I was 40,000 feet above the ground when I realized how glad I was that I’d seen Steel Magnolias.
 
During a flight a few years ago the woman seated next to me began having a seizure. I hit the button to call the flight attendant, but the attendant had very little idea of how to help. Luckily, I had taken a class on first-aid and was a first-responder with a volunteer paramedic squad in college. I remembered to check the woman for bracelets indicating she was diabetic or epileptic, but I was unable to locate any such information. With my extremely limited knowledge all I could remember was to make sure she was unable to bite her tongue during the seizures, but what else could I do to help?

I searched my brain; Steel Magnolias, I thought! Julia Roberts had a diabetic seizure in the movie, and orange juice helped her. But my thoughts were interrupted when someone located a physician onboard. “Saved!” I thought.
 
Unfortunately, the physician openly stated that “he was a plastic surgeon,” who oddly, despite having attended medical school, appeared to have no idea how to help. Steel Magnolias it was.
 
The flight attendant brought orange juice. We dropped the juice into the corner of her mouth with a coffee stirrer. The woman stopped seizing; she was diabetic and the orange juice contained enough sugar to stop the seizure.
 
While I laugh to this day at the physician announcing he was unable to help because he was a plastic surgeon, seizures of any variety are obviously a very serious matter. November, which is National Epilepsy Awareness month, is a great time to find out more about seizures and their various causes, symptoms, and treatments. You just never know when this information will come in handy.
 
For coders, it is also a great time to brush up on seizure coding. The terms a physician uses to document dictate which seizure codes to report. Per Coding Clinic, First Quarter, 2008 note the following:
  • When a physician documents “seizures” or “single seizure,” coders should report symptom code 780.39
  • When a physician documents a “seizure disorder,” coders should report a code from category 345.9x (epilepsy)
  • When a physician documents “recurrent” or “repetitive seizures,” coders should also report a code from category 345.9x

According to the Merck Manual, epilepsy is “a recurrent brain dysfunction associated with abnormal electrical discharges of neurons in the brain characterized by periods of altered consciousness and motor activity.”

For more on epilepsy, visit the Epilepsy Foundation Web site at www.epilepsyfoundation.org.

Editor's note: Shannon McCall, RHIA, CCS, CCS-P, CPC-I, is the director of coding and HIM for HCPro, Inc., in Chesterfield, VA. You can e-mail her at smccall@hcpro.com.

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