ICD-10 Coding for Narcolepsy Without Cataplexy(G47.419, G47.429)
Complete ICD-10-CM coding and documentation guide for Narcolepsy Without Cataplexy. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Narcolepsy Without Cataplexy
G47.4Primary Range
Sleep disorders
This range includes codes for narcolepsy and other sleep disorders, with G47.419 specifically for narcolepsy without cataplexy.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| G47.419 | Narcolepsy without cataplexy | Use when narcolepsy is confirmed without cataplexy and no underlying condition is present. |
|
| G47.429 | Narcolepsy in conditions classified elsewhere | Use when narcolepsy is secondary to another 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 narcolepsy without cataplexy
Essential facts and insights about Narcolepsy Without Cataplexy
Primary ICD-10-CM Codes for narcolepsy without cataplexy
Decision Criteria
clinical Criteria
- MSLT results with mean sleep latency ≤8 minutes and ≥2 SOREMPs
documentation Criteria
- Explicit documentation of no cataplexy
Applicable To
- Primary narcolepsy without cataplexy
Clinical Validation Requirements
- MSLT showing mean sleep latency ≤8 minutes with ≥2 SOREMPs
- PSG ruling out sleep apnea (AHI <5)
Code-Specific Risks
- Incorrectly coding secondary narcolepsy as primary
- Failing to document absence of cataplexy
Coding Notes
- Ensure documentation explicitly states absence of cataplexy.
G47.429 - Narcolepsy in conditions classified elsewhere
Use when narcolepsy is secondary to another condition.
Applicable To
- Secondary narcolepsy without cataplexy
Excludes
- Primary narcolepsy without cataplexy (G47.419)
Clinical Validation Requirements
- Documentation of underlying condition causing narcolepsy
Coding Notes
Ensure underlying condition is documented and coded first.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Excessive daytime sleepiness
R40.0Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Narcolepsy Without Cataplexy to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code G47.419.
Impact
Clinical: Misdiagnosis risk, Regulatory: Non-compliance with coding standards, Financial: Potential claim denials
Mitigation Strategy
Train staff on documentation standards., Use templates that prompt for specific details.
Impact
Reimbursement: Incorrect DRG assignment, Compliance: Non-compliance with coding guidelines, Data Quality: Inaccurate clinical data representation
Mitigation Strategy
Use G47.429 and code the underlying condition first.
Impact
Lack of detailed sleep study results can lead to audit issues.
Mitigation Strategy
Ensure all sleep study results are documented in the patient's record.
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 Narcolepsy Without Cataplexy, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Narcolepsy Without Cataplexy
Use these documentation templates to ensure complete and accurate documentation for Narcolepsy Without Cataplexy. These templates include all required elements for proper coding and billing.
Narcolepsy without cataplexy diagnosis
Specialty: NeurologyRequired Elements
- Sleep history
- MSLT results
- PSG results
- Absence of cataplexy
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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