ICD-10 Coding for Central Sleep Apnea(G47.31, G47.32, G47.37)
Complete ICD-10-CM coding and documentation guide for Central Sleep Apnea. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Central Sleep Apnea
G47.3Primary Range
Sleep apnea
This range includes all types of sleep apnea, with specific codes for central sleep apnea.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| G47.31 | Central sleep apnea | Use when central sleep apnea is confirmed by PSG and is not secondary to another condition. |
|
| G47.32 | Central sleep apnea in high altitude periodic breathing | Use when central sleep apnea is due to high altitude periodic breathing. |
|
| G47.37 | Central sleep apnea in conditions classified elsewhere | Use when central sleep apnea is secondary to another condition. |
|
Clinical Decision Support
Always review the patient's clinical documentation thoroughly. When in doubt, choose the more specific code and ensure documentation supports it.
Key Information: ICD-10 code for central sleep apnea
Essential facts and insights about Central Sleep Apnea
Primary ICD-10-CM Codes for central sleep apnea
Decision Criteria
clinical Criteria
- PSG confirms central apneas ≥50% of total events
documentation Criteria
- Absence of respiratory effort during apneic events
Applicable To
- Idiopathic central sleep apnea
Clinical Validation Requirements
- Polysomnography showing central apneas ≥50% of total events
- Absence of respiratory effort during apneic events
Code-Specific Risks
- Confusing with obstructive sleep apnea
- Using without PSG confirmation
Coding Notes
- Ensure PSG results are documented to support the use of this code.
G47.32 - Central sleep apnea in high altitude periodic breathing
Use when central sleep apnea is due to high altitude periodic breathing.
Clinical Validation Requirements
- Patient recently ascended to ≥2,500 meters
- PSG shows periodic breathing pattern
Coding Notes
Ensure altitude and breathing pattern are documented.
G47.37 - Central sleep apnea in conditions classified elsewhere
Use when central sleep apnea is secondary to another condition.
Applicable To
- Central sleep apnea due to drug use
- Central sleep apnea with Cheyne-Stokes respiration
Clinical Validation Requirements
- Documentation states 'Central apneas secondary to [condition]'
- Cheyne-Stokes respiration due to heart failure
Coding Notes
Sequence underlying condition first.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Differential Codes
Alternative codes to consider when ruling out similar conditions to the primary diagnosis.
Obstructive sleep apnea
G47.33Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Central Sleep Apnea to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code G47.31.
Impact
Clinical: Leads to inappropriate treatment plans., Regulatory: Non-compliance with documentation standards., Financial: Potential claim denials due to lack of specificity.
Mitigation Strategy
Always specify the type of sleep apnea in documentation., Ensure PSG results are reviewed and documented.
Impact
Reimbursement: Incorrect coding may lead to denied claims., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate clinical data representation.
Mitigation Strategy
Use G47.37 + R06.3 for CSA with Cheyne-Stokes respiration.
Impact
Lack of PSG documentation for CSA claims.
Mitigation Strategy
Ensure PSG reports are included in patient records.
Documentation errors, coding pitfalls, and audit risks are interconnected aspects of medical coding and billing. Addressing all three areas helps ensure accurate coding, optimal reimbursement, and regulatory compliance.
Frequently Asked Questions
Common questions about ICD-10 coding for Central Sleep Apnea, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Central Sleep Apnea
Use these documentation templates to ensure complete and accurate documentation for Central Sleep Apnea. These templates include all required elements for proper coding and billing.
Central sleep apnea with heart failure
Specialty: PulmonologyRequired Elements
- PSG results
- AHI and CAI values
- Underlying conditions
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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