ICD-10 Codes for Sleep Disorders

Sleep disorders can impact a healthy lifestyle.

Are you getting enough sleep? So often we sacrifice sleep for work, housework, family demands, or watching that good movie or basketball game. Sleep is just as important as a healthy diet and regular physical activity. Poor sleep habits can lead to an increased health risk for obesity, diabetes mellitus, hypertension, coronary artery disease, stroke, or poor mental health.

How much sleep do you need? According to the American Academy of Sleep Medicine, you need this much sleep if you are:

• 4 – 12 months > 12 – 16 hours
• 1 – 2 years > 11 – 14 hours
• 3 – 5 years > 10 – 13 hours
• 6 – 12 years > 9 – 12 hours
• 13 – 18 years > 8 – 10 hours
• 18 – 60 years > 7 or more hours

As previously mentioned, a lack of sleep can lead to some chronic disease such as the following:

• Diabetes, Type 2 – sleep duration and quality are predictors of A1C which is a marker for blood sugar control.
• Cardiovascular Disease – sleep apnea is a predictor of cardiovascular disease.
• Obesity – insufficient sleep impacts the function of the hypothalamus which regulates appetite and energy usage in children.
• Depression – sleep disturbance can be a symptom of depression

Some other key sleep disorder diagnoses include the following:

• Insomnia which is the inability to initiate or maintain sleep.The code for this condition is G47.00 and it is not a Comorbid/Complication (CC) or Major Comorbid/Complication (MCC). If insomnia is associated with drug/alcohol use, abuse, or dependence, then the condition will be a Hierarchical Condition Category (HCC).
• Narcolepsy is excessive daytime sleepiness combined with sudden muscle weakness. The ICD-10-CM code is G47.419. The code is not a CC or MCC and does not qualify as an HCC.
• Restless Leg Syndrome (RLS) is a “creeping” sensation associated with aches and pains throughout the legs and is relieved by movement of the legs. This condition is coded as G25.81 and is not a CC or MCC. This code has not been assigned HCC status.
• Sleep apnea is an interruption of regular breathing or obstruction of the airway during sleep. Signs and symptoms may include snoring, gasping, or snorting noises during sleep. This condition may lead to congestive heart failure. Sleep apnea is coded as G47.30 and is not a CC or MCC. This condition is not on the HCC list either.  

The Center for Disease Control  and Prevention (CDC) recommends that to improve your sleep habits you should have a consistent bedtime; have a quiet, dark, and relaxing bedroom; remove electronic devices; avoid large meals, caffeine, and alcohol before bedtime; avoid nicotine/tobacco; and get exercise during the day. Quality is just as important as quantity. If you are feeling sleepy in the morning, your sleep quality may be suspicious. Finally, you should report your sleep habits to your physician for early detection and prevention of other chronic diseases or sleep disorders.

Resources:

Centers for Medicare and Medicaid Services (CMS) Mid-Year 2019 HCC Mappings.

Centers for Medicare and Medicaid Services (CMS) v36 Table J (Complete List of CCs) and Table I (Complete List of MCCs).  

Centers for Disease Control and Prevention (CDC).

Listen to Laurie’s June 25, 2019 Coding Report segment about I10 coding sleep disorders on Talk Ten Tuesdays