ICD-10 Coding for Hypoventilation Syndrome(E66.2, G47.36)
Complete ICD-10-CM coding and documentation guide for Hypoventilation Syndrome. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Hypoventilation Syndrome
E66-E66.9Primary Range
Obesity and other hyperalimentation
Includes codes for obesity-related conditions, including hypoventilation due to obesity.
Sleep disorders
Includes codes for sleep-related breathing disorders, including hypoventilation.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| E66.2 | Morbid obesity with alveolar hypoventilation | Use when hypoventilation is directly caused by obesity. |
|
| G47.36 | Sleep-related hypoventilation in conditions classified elsewhere | Use when hypoventilation is due to a neuromuscular or structural disorder. |
|
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 hypoventilation syndrome
Essential facts and insights about Hypoventilation Syndrome
Primary ICD-10-CM Codes for hypoventilation syndrome
Decision Criteria
clinical Criteria
- BMI ≥30 and PaCO₂ ≥45 mmHg
documentation Criteria
- Explicit mention of 'morbid obesity'
Applicable To
- Obesity hypoventilation syndrome
- Pickwickian syndrome
Excludes
- Obstructive sleep apnea (G47.33)
Clinical Validation Requirements
- BMI ≥30
- PaCO₂ ≥45 mmHg
- Exclusion of other causes like COPD
Code-Specific Risks
- Incorrect use without explicit documentation of 'morbid obesity'.
Coding Notes
- Ensure documentation explicitly states 'morbid obesity'.
G47.36 - Sleep-related hypoventilation in conditions classified elsewhere
Use when hypoventilation is due to a neuromuscular or structural disorder.
Applicable To
- Hypoventilation due to neuromuscular disorders
Excludes
- Central sleep apnea (G47.30)
Clinical Validation Requirements
- PSG showing hypoventilation
- Confirmed neuromuscular diagnosis
Coding Notes
Ensure proper sequencing with the underlying condition.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Hypoventilation Syndrome to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code E66.2.
Impact
Clinical: Misclassification of patient condition., Regulatory: Non-compliance with ICD-10 coding rules., Financial: Potential for claim denials.
Mitigation Strategy
Educate providers on documentation standards., Use templates that prompt for 'morbid obesity'.
Impact
Reimbursement: May lead to denied claims or lower reimbursement., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate health records and data reporting.
Mitigation Strategy
Ensure provider documents 'morbid obesity' explicitly.
Impact
Using R06.8 without documented etiology.
Mitigation Strategy
Ensure etiology is documented or query provider.
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 Hypoventilation Syndrome, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Hypoventilation Syndrome
Use these documentation templates to ensure complete and accurate documentation for Hypoventilation Syndrome. These templates include all required elements for proper coding and billing.
Obesity Hypoventilation Syndrome Diagnosis
Specialty: PulmonologyRequired Elements
- Diagnosis of OHS
- BMI and PaCO₂ levels
- Exclusion of other causes
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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