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ICD-10 Guide
ICD-10 CodesR56.00

R56.00

Simple febrile convulsions

BILLABLE STATUSYes
IMPLEMENTATION DATEOctober 1, 2015
LAST UPDATED09/11/2025

Code Description

ICD-10 R56.00 is a billable code used to indicate a diagnosis of simple febrile convulsions.

Key Diagnostic Point:

Simple febrile convulsions are seizures that occur in children, typically between the ages of 6 months and 5 years, triggered by a fever, often due to an underlying infection. These convulsions are characterized by generalized tonic-clonic movements and usually last less than 15 minutes. They are classified as simple if they are brief, occur only once within a 24-hour period, and do not have any focal features. The fever associated with these convulsions is usually benign and self-limiting, often resolving as the underlying infection is treated. While febrile convulsions can be alarming for parents, they are generally not associated with long-term neurological damage or an increased risk of epilepsy. Clinical evaluation typically includes a thorough history and physical examination, with consideration of laboratory tests to rule out other causes of seizures, such as metabolic disturbances or central nervous system infections.

Code Complexity Analysis

Complexity Rating: Low

Low Complexity

Complexity Factors

  • Clear clinical definition and criteria for diagnosis
  • Well-established guidelines for documentation
  • Limited differential diagnoses
  • Commonly encountered in pediatric practice

Audit Risk Factors

  • Inadequate documentation of seizure duration
  • Failure to document the absence of focal features
  • Misclassification of simple vs. complex febrile convulsions
  • Lack of documentation regarding the fever's etiology

Specialty Focus

Medical Specialties

Internal Medicine

Documentation Requirements

Document the patient's history of fever, duration of convulsion, and any prior episodes.

Common Clinical Scenarios

A child presents with a fever and generalized convulsions during a routine visit.

Billing Considerations

Ensure to differentiate from other seizure types and document the absence of neurological deficits.

Emergency Medicine

Documentation Requirements

Detailed account of the event, including onset, duration, and postictal state.

Common Clinical Scenarios

A child is brought to the ER after experiencing a seizure during a febrile illness.

Billing Considerations

Rapid assessment of vital signs and neurological status is crucial; document any interventions performed.

Coding Guidelines

Inclusion Criteria

Use R56.00 When
  • Follow the ICD
  • CM guidelines for coding seizures, ensuring that the diagnosis is supported by clinical documentation
  • The code R56
  • 00 should be used when the convulsion is simple and not associated with any underlying neurological condition

Exclusion Criteria

Do NOT use R56.00 When
No specific exclusions found.

Related CPT Codes

99284CPT Code

Emergency department visit, high severity

Clinical Scenario

Used when a child presents to the ER with febrile convulsions.

Documentation Requirements

Document the severity of the condition and the interventions performed.

Specialty Considerations

Emergency physicians should ensure thorough documentation of the patient's neurological status.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of febrile convulsions, improving the accuracy of data collection and reimbursement processes.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of febrile convulsions, improving the accuracy of data collection and reimbursement processes.

Reimbursement & Billing Impact

reimbursement processes.

Resources

Clinical References

  • •
    American Academy of Pediatrics Guidelines on Febrile Seizures

Coding & Billing References

  • •
    American Academy of Pediatrics Guidelines on Febrile Seizures

Frequently Asked Questions

What is the typical age range for simple febrile convulsions?

Simple febrile convulsions typically occur in children aged 6 months to 5 years.

Are simple febrile convulsions harmful?

Generally, simple febrile convulsions are not harmful and do not lead to long-term neurological issues.