ICD-10 Coding for Hypersomnolence(G47.11, G47.12, G47.14)
Complete ICD-10-CM coding and documentation guide for Hypersomnolence. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Hypersomnolence
G47.1Primary Range
Disorders of hypersomnolence
This range includes codes for various types of hypersomnolence, including idiopathic and those 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 |
|---|---|---|---|
| G47.11 | Idiopathic hypersomnia with long sleep time | Use when the patient has idiopathic hypersomnia with documented long sleep time. |
|
| G47.12 | Idiopathic hypersomnia without long sleep time | Use when the patient has idiopathic hypersomnia but does not meet criteria for long sleep time. |
|
| G47.14 | Hypersomnia due to medical condition | Use when hypersomnia is directly caused by another medical 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 hypersomnolence
Essential facts and insights about Hypersomnolence
Primary ICD-10-CM Codes for hypersomnolence
Decision Criteria
clinical Criteria
- Patient has excessive sleep duration confirmed by actigraphy.
documentation Criteria
- MSLT and PSG results must be documented.
Applicable To
- Idiopathic hypersomnia with more than 10 hours of sleep
Clinical Validation Requirements
- MSLT mean latency <8 minutes
- Nocturnal PSG >10 hours
- Actigraphy confirms >10 hours sleep
Code-Specific Risks
- Incorrectly coding as G47.10 when specific criteria are met for G47.11.
Coding Notes
- Ensure documentation includes specific sleep duration and test results.
G47.12 - Idiopathic hypersomnia without long sleep time
Use when the patient has idiopathic hypersomnia but does not meet criteria for long sleep time.
Applicable To
- Idiopathic hypersomnia with normal sleep duration
Excludes
- Narcolepsy (G47.4)
- Obstructive sleep apnea (G47.33)
Clinical Validation Requirements
- MSLT mean latency <8 minutes
- PSG shows 6-10 hours of sleep
Coding Notes
Ensure sleep duration is documented accurately.
G47.14 - Hypersomnia due to medical condition
Use when hypersomnia is directly caused by another medical condition.
Applicable To
- Hypersomnia secondary to conditions like Parkinson’s or MS
Excludes
- Primary hypersomnia (G47.1x)
Clinical Validation Requirements
- Documentation of underlying medical condition causing hypersomnia
Coding Notes
Ensure the underlying condition is documented and coded.
Differential Codes
Alternative codes to consider when ruling out similar conditions to the primary diagnosis.
Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Hypersomnolence to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code G47.11.
Impact
Clinical: May lead to misdiagnosis or inappropriate treatment., Regulatory: Non-compliance with documentation standards., Financial: Potential claim denials or reduced reimbursement.
Mitigation Strategy
Ensure all sleep study results are included in patient records., Use templates to guide documentation.
Impact
Reimbursement: Incorrect coding may lead to claim denials., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate data on hypersomnia prevalence.
Mitigation Strategy
Review sleep study results and actigraphy to select the correct specific code.
Impact
Using unspecified codes when specific criteria are met.
Mitigation Strategy
Regular training on hypersomnia coding and documentation requirements.
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 Hypersomnolence, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Hypersomnolence
Use these documentation templates to ensure complete and accurate documentation for Hypersomnolence. These templates include all required elements for proper coding and billing.
Idiopathic Hypersomnia with Long Sleep Time
Specialty: NeurologyRequired Elements
- Patient history
- MSLT results
- PSG results
- Actigraphy data
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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