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ICD-10 Coding for Circadian Rhythm Sleep Disorder(G47.21, G47.20)

Complete ICD-10-CM coding and documentation guide for Circadian Rhythm Sleep Disorder. Includes clinical validation requirements, documentation requirements, and coding pitfalls.

Also known as:

CRSDSleep-Wake Cycle Disorder

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Related ICD-10 Code Ranges

Complete code families applicable to Circadian Rhythm Sleep Disorder

G47.2-G47.29Primary Range

Circadian Rhythm Sleep Disorders

This range covers all types of circadian rhythm sleep disorders, including delayed sleep phase, advanced sleep phase, and shift work disorder.

Code Comparison: When to Use Each Code

Compare key differences between these codes to ensure accurate selection

CodeDescriptionWhen to UseKey Documentation
G47.21Circadian rhythm sleep disorder, delayed sleep phase typeUse when delayed sleep phase is confirmed by sleep logs and actigraphy.
  • Sleep logs showing habitual sleep onset after 2 AM for ≥3 months
  • Actigraphy confirming 3-hour delay vs. desired schedule
G47.20Circadian rhythm sleep disorder, unspecifiedUse when the specific type of circadian rhythm disorder is not documented.
  • General documentation of circadian rhythm disruption without specific type

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 delayed sleep phase disorder

Essential facts and insights about Circadian Rhythm Sleep Disorder

The ICD-10 code for delayed sleep phase disorder is G47.21. It requires documentation of a consistent delay in sleep onset confirmed by actigraphy.

Primary ICD-10-CM Codes for circadian rhythm disorder

G47.21
Circadian rhythm sleep disorder, delayed sleep phase type
Billable Code

Decision Criteria

clinical Criteria

  • Delayed sleep onset confirmed by actigraphy

Applicable To

  • Delayed sleep phase syndrome

Excludes

Clinical Validation Requirements

  • Sleep logs showing habitual sleep onset after 2 AM for ≥3 months
  • Actigraphy confirming 3-hour delay vs. desired schedule

Code-Specific Risks

  • Incorrectly using G47.20 when the type is specified

Coding Notes

  • Ensure documentation includes specific sleep pattern details and actigraphy results.
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Ancillary Codes

Additional codes that should be used in conjunction with the main diagnosis codes when applicable.

Shift work disorder

Z56.2
Use with G47.26 when shift work is a contributing factor.

Differential Codes

Alternative codes to consider when ruling out similar conditions to the primary diagnosis.

Insomnia

G47.0-
Insomnia lacks a consistent circadian pattern and persists regardless of timing.

Documentation & Coding Risks

Avoid these common documentation and coding issues when documenting Circadian Rhythm Sleep Disorder to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code G47.21.

Impact

Clinical: May lead to misdiagnosis or inappropriate treatment., Regulatory: Fails to meet documentation standards., Financial: Could result in denied claims or reduced reimbursement.

Mitigation Strategy

Ensure detailed documentation of sleep patterns, Use actigraphy and sleep logs for validation

Impact

Reimbursement: May lead to incorrect DRG assignment and affect reimbursement., Compliance: Non-compliance with coding guidelines., Data Quality: Decreases accuracy of clinical data.

Mitigation Strategy

Query the provider to specify the subtype based on available documentation.

Impact

Lack of detailed sleep pattern documentation can lead to audit issues.

Mitigation Strategy

Ensure comprehensive documentation of sleep logs and actigraphy.

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 Circadian Rhythm Sleep Disorder, with expert answers to help guide accurate code selection and documentation.

Documentation Templates for Circadian Rhythm Sleep Disorder

Use these documentation templates to ensure complete and accurate documentation for Circadian Rhythm Sleep Disorder. These templates include all required elements for proper coding and billing.

Delayed Sleep Phase Disorder

Specialty: Neurology

Required Elements

  • Patient-reported sleep times
  • Actigraphy data
  • Duration of symptoms

Example Documentation

**Subjective**: "I can't fall asleep before 3 AM even when I try to go to bed at 11 PM." **Objective**: - Sleep log (14 days): Avg. sleep onset 2:45 AM ± 30 min - Actigraphy: Confirms delayed sleep-wake pattern with no environmental causes - DLMO: 1:30 AM (abnormally late) **Assessment**: G47.21 - Delayed sleep phase disorder, validated by actigraphy and DLMO **Plan**: Chronotherapy with 0.5 mg melatonin at 10 PM

Examples: Poor vs. Good Documentation

Poor Documentation Example
Patient has trouble sleeping.
Good Documentation Example
Patient reports inability to fall asleep before 2 AM for 6 months. Actigraphy shows average sleep onset at 2:30 AM with 7-day sleep log consistency.
Explanation
The good example provides specific sleep pattern details and duration, which are necessary for accurate coding.

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