ICD-10 Coding for Chronic Insomnia(F51.05, G47.00)
Complete ICD-10-CM coding and documentation guide for Chronic Insomnia. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Chronic Insomnia
F51.0-F51.9Primary Range
Sleep disorders not due to a substance or known physiological condition
This range includes codes for insomnia disorders, including chronic insomnia not attributed to substances or medical conditions.
Insomnia
This range covers insomnia codes, including unspecified insomnia and insomnia due to medical conditions.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| F51.05 | Chronic insomnia disorder | Use when insomnia is chronic, not due to substances or medical conditions, and persists for at least 3 months. |
|
| G47.00 | Insomnia, unspecified | Use when insomnia is documented without specification of chronicity or cause. |
|
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 chronic insomnia
Essential facts and insights about Chronic Insomnia
Primary ICD-10-CM Codes for chronic insomnia
Decision Criteria
clinical Criteria
- Symptoms lasting ≥3 months with significant daytime impairment.
coding Criteria
- Chronic insomnia not attributed to substances or medical conditions.
documentation Criteria
- Detailed sleep history and exclusion of other conditions.
Applicable To
- Chronic insomnia not due to substances or known physiological conditions
Clinical Validation Requirements
- Symptoms persisting for ≥3 months
- Sleep logs confirming sleep disturbance
- Exclusion of other sleep disorders such as OSA
Code-Specific Risks
- Confusion with acute insomnia codes
- Incorrect sequencing with mental disorder codes
Coding Notes
- Ensure documentation specifies chronicity and excludes other causes.
G47.00 - Insomnia, unspecified
Use when insomnia is documented without specification of chronicity or cause.
Applicable To
- Insomnia not specified as chronic or acute
Excludes
- Insomnia due to mental disorder (F32.9)
- Insomnia due to substance (F10-F19)
Clinical Validation Requirements
- Lack of specific chronicity or etiology in documentation
Coding Notes
Ensure documentation specifies if insomnia is chronic or acute to avoid defaulting to unspecified.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Insomnia, unspecified
G47.00Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Chronic Insomnia to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code F51.05.
Impact
Clinical: May lead to misdiagnosis and inappropriate treatment., Regulatory: Non-compliance with coding guidelines., Financial: Potential denial of claims due to insufficient documentation.
Mitigation Strategy
Include a thorough sleep history and differential diagnosis., Document exclusion of conditions like OSA.
Impact
Reimbursement: Potential underpayment due to non-specific coding., Compliance: Risk of audit failure due to lack of specificity., Data Quality: Decreased accuracy in clinical data reporting.
Mitigation Strategy
Ensure documentation specifies chronicity to use F51.05.
Impact
Failure to document chronicity can lead to audit discrepancies.
Mitigation Strategy
Use standardized sleep logs and patient interviews to confirm chronicity.
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 Chronic Insomnia, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Chronic Insomnia
Use these documentation templates to ensure complete and accurate documentation for Chronic Insomnia. These templates include all required elements for proper coding and billing.
Chronic insomnia in a psychiatric setting
Specialty: PsychiatryRequired Elements
- Sleep history
- Daytime impairment
- Exclusion of other disorders
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
Need help with ICD-10 coding for Chronic Insomnia? Ask your questions below.