ICD-10 Coding for Insomnia Unspecified(G47.00)
Complete ICD-10-CM coding and documentation guide for Insomnia Unspecified. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Insomnia Unspecified
G47.00-G47.09Primary Range
Sleep disorders
This range includes codes for various sleep disorders, with G47.00 specifically for unspecified insomnia.
Key Information: ICD-10 code for insomnia unspecified
Essential facts and insights about Insomnia Unspecified
Primary ICD-10-CM Code for insomnia unspecified
Decision Criteria
clinical Criteria
- Chronic insomnia without identifiable cause
coding Criteria
- No underlying medical or psychiatric condition documented
Applicable To
- Chronic insomnia without identifiable cause
Clinical Validation Requirements
- Sleep diary showing ≥3 nights/week of >30 min sleep latency
- No improvement with OTC sleep aids
- Epworth Sleepiness Scale (ESS) score <10
Code-Specific Risks
- Incorrect coding if underlying condition is present but not documented.
Coding Notes
- Ensure no underlying condition is present before using G47.00.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Insomnia due to medical condition
G47.01Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Insomnia Unspecified to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code G47.00.
Impact
Clinical: Inaccurate diagnosis and treatment planning., Regulatory: Potential audit issues., Financial: Claim denials due to insufficient documentation.
Mitigation Strategy
Ensure documentation includes specific duration and frequency of symptoms.
Impact
Reimbursement: Incorrect coding can lead to denied claims., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate patient records.
Mitigation Strategy
Document and code the underlying condition first, then use G47.01.
Impact
Inadequate documentation of insomnia symptoms and duration.
Mitigation Strategy
Use structured templates to ensure comprehensive documentation.
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 Insomnia Unspecified, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Insomnia Unspecified
Use these documentation templates to ensure complete and accurate documentation for Insomnia Unspecified. These templates include all required elements for proper coding and billing.
Primary Care Evaluation
Specialty: Primary CareRequired Elements
- Sleep history
- Symptom duration
- Impact on daily activities
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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