G40.419: Other generalized epilepsy and epileptic syndromes, intractable, without status epilepticus

G40.419, other generalized epilepsy and epileptic syndromes, intractable, without status epilepticus, is listed as a covered diagnosis in 17 Medicare billing and coding articles that apply to 50 HCPCS Level II codes, including G0480 (Drug test(s), definitive, utilizing (1) drug…), G0483 (Drug test(s), definitive, utilizing (1) drug…), G0482 (Drug test(s), definitive, utilizing (1) drug…). The articles come from 7 Medicare contractors. A listed diagnosis supports medical necessity only; coverage still depends on the LCD's criteria and on documentation in the medical record.

HCPCS Level II codes with G40.419 as a covered diagnosis

CodeDescriptionMedicare coverageDMEPOS fee 2026 (state range)Articles listing it
G0480Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not limited to gc/ms (any type, single or tandem) and lc/ms (any type, single or tandem and excluding immunoassays (e.g., ia, eia, elisa, emit, fpia) and enzymatic methods (e.g., alcohol dehydrogenase)), (2) stable isotope or other universally recognized internal standards in all samples (e.g., to control for matrix effects, interferences and variations in signal strength), and (3) method or drug-specific calibration and matrix-matched quality control material (e.g., to control for instrument variations and mass spectral drift); qualitative or quantitative, all sources, includes specimen validity testing, per day; 1-7 drug class(es), including metabolite(s) if performedCarrier judgment—7
G0483Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not limited to gc/ms (any type, single or tandem) and lc/ms (any type, single or tandem and excluding immunoassays (e.g., ia, eia, elisa, emit, fpia) and enzymatic methods (e.g., alcohol dehydrogenase)), (2) stable isotope or other universally recognized internal standards in all samples (e.g., to control for matrix effects, interferences and variations in signal strength), and (3) method or drug-specific calibration and matrix-matched quality control material (e.g., to control for instrument variations and mass spectral drift); qualitative or quantitative, all sources, includes specimen validity testing, per day; 22 or more drug class(es), including metabolite(s) if performedCarrier judgment—7
G0482Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not limited to gc/ms (any type, single or tandem) and lc/ms (any type, single or tandem and excluding immunoassays (e.g., ia, eia, elisa, emit, fpia) and enzymatic methods (e.g., alcohol dehydrogenase)), (2) stable isotope or other universally recognized internal standards in all samples (e.g., to control for matrix effects, interferences and variations in signal strength), and (3) method or drug-specific calibration and matrix-matched quality control material (e.g., to control for instrument variations and mass spectral drift); qualitative or quantitative, all sources, includes specimen validity testing, per day; 15-21 drug class(es), including metabolite(s) if performedCarrier judgment—7
G0481Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not limited to gc/ms (any type, single or tandem) and lc/ms (any type, single or tandem and excluding immunoassays (e.g., ia, eia, elisa, emit, fpia) and enzymatic methods (e.g., alcohol dehydrogenase)), (2) stable isotope or other universally recognized internal standards in all samples (e.g., to control for matrix effects, interferences and variations in signal strength), and (3) method or drug-specific calibration and matrix-matched quality control material (e.g., to control for instrument variations and mass spectral drift); qualitative or quantitative, all sources, includes specimen validity testing, per day; 8-14 drug class(es), including metabolite(s) if performedCarrier judgment—7
G0659Drug test(s), definitive, utilizing drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including but not limited to gc/ms (any type, single or tandem) and lc/ms (any type, single or tandem), excluding immunoassays (e.g., ia, eia, elisa, emit, fpia) and enzymatic methods (e.g., alcohol dehydrogenase), performed without method or drug-specific calibration, without matrix-matched quality control material, or without use of stable isotope or other universally recognized internal standard(s) for each drug, drug metabolite or drug class per specimen; qualitative or quantitative, all sources, includes specimen validity testing, per day, any number of drug classesCarrier judgment—7
A9552Fluorodeoxyglucose f-18 fdg, diagnostic, per study dose, up to 45 millicuriesCarrier judgment—2
A9597Positron emission tomography radiopharmaceutical, diagnostic, for tumor identification, not otherwise classifiedCarrier judgment—2
A9598Positron emission tomography radiopharmaceutical, diagnostic, for non-tumor identification, not otherwise classifiedCarrier judgment—2
A9601Flortaucipir f 18 injection, diagnostic, 1 millicurieCarrier judgment—2
G0340Image-guided robotic linear accelerator-based stereotactic radiosurgery, delivery including collimator changes and custom plugging, fractionated treatment, all lesions, per session, second through fifth sessions, maximum five sessions per course of treatmentCarrier judgment—2
G0339Image-guided robotic linear accelerator-based stereotactic radiosurgery, complete course of therapy in one session or first session of fractionated treatmentCarrier judgment—2
G0563Stereotactic body radiation therapy, treatment delivery, per fraction to 1 or more lesions, including image guidance and real-time positron emissions-based delivery adjustments to 1 or more lesions, entire course not to exceed 5 fractionsCarrier judgment—1
G0451Development testing, with interpretation and report, per standardized instrument formCarrier judgment—2
J1575Injection, immune globulin/hyaluronidase, (hyqvia), 100 mg immuneglobulinCarrier judgment—1
J1569Injection, immune globulin, (gammagard liquid/gammagard liquid erc), 500 mgSpecial coverage instructions apply—1
J1561Injection, immune globulin, (gamunex-c/gammaked), non-lyophilized (e.g., liquid), 500 mgSpecial coverage instructions apply—1
J1459Injection, immune globulin (privigen), intravenous, non-lyophilized (e.g., liquid), 500 mgCarrier judgment—1
J1557Injection, immune globulin, (gammaplex), intravenous, non-lyophilized (e.g., liquid), 500 mgCarrier judgment—1
J1556Injection, immune globulin (bivigam), 500 mgCarrier judgment—1
J1568Injection, immune globulin, (octagam), intravenous, non-lyophilized (e.g., liquid), 500 mgCarrier judgment—1
J1566Injection, immune globulin, intravenous, lyophilized (e.g., powder), not otherwise specified, 500 mgSpecial coverage instructions apply—1
J1554Injection, immune globulin (asceniv), 500 mgCarrier judgment—1
J1599Injection, immune globulin, intravenous, non-lyophilized (e.g., liquid), not otherwise specified, 500 mgCarrier judgment—1
J1572Injection, immune globulin, (flebogamma/flebogamma dif), intravenous, non-lyophilized (e.g., liquid), 500 mgSpecial coverage instructions apply—1
J1460Injection, gamma globulin, intramuscular, 1 ccSpecial coverage instructions apply—1

25 more codes are listed. See every code with payment by region in Caduvo.

Medicare policy articles listing G40.419

2 more articles list G40.419.

A diagnosis listed as covered in a billing and coding article supports medical necessity for the article's codes; it does not guarantee payment. Coverage depends on the LCD's criteria, the contractor's jurisdiction and documentation in the medical record.

Other G40 diagnoses (Epilepsy and recurrent seizures)

Frequently asked questions

Does Medicare cover G40.419 (Other generalized epilepsy and epileptic syndromes…)?

Medicare covers items and services, not diagnoses. 17 Medicare billing and coding articles list G40.419 as a covered diagnosis for 50 HCPCS Level II codes: the diagnosis can support medical necessity for those codes, but payment still depends on the LCD's coverage criteria and the medical record.

Which HCPCS codes can be billed with ICD-10 G40.419?

The Level II codes from the policies most specific to this diagnosis are G0480 (Drug test(s), definitive, utilizing (1) drug…, 7 articles); G0483 (Drug test(s), definitive, utilizing (1) drug…, 7 articles); G0482 (Drug test(s), definitive, utilizing (1) drug…, 7 articles); G0481 (Drug test(s), definitive, utilizing (1) drug…, 7 articles); G0659 (Drug test(s), definitive, utilizing drug identification…, 7 articles). Code choice depends on the item supplied; check each code's descriptor.

Which Medicare policy articles list G40.419?

A53134 (Billing and Coding: NCD Coding Article for Positron Emission Tomography (PET) Scans Used for Non-Oncologic Conditions); A59049 (Billing and Coding: NCD Coding Article for Positron Emission Tomography (PET) Scans Used for Non-Oncologic Conditions); A56874 (Billing and Coding: Stereotactic Radiation Therapy: Stereotactic Radiosurgery (SRS) and Stereotactic Body Radiation Therapy (SBRT)), and 14 more articles.

What is ICD-10-CM code G40.419?

G40.419 is the ICD-10-CM code for other generalized epilepsy and epileptic syndromes, intractable, without status epilepticus, in category G40 (Epilepsy and recurrent seizures), chapter 6: Diseases of the nervous system.

Next steps

Sources: CMS Medicare Coverage Database billing and coding articles (covered ICD-10 code lists and HCPCS links); ICD-10-CM FY2026; CMS HCPCS Level II release October 2026; CMS DMEPOS fee schedule 2026 (non-rural state fees). Not billing or legal advice.

Chapter 6: Diseases of the nervous system · All diagnoses · HCPCS lookup