ICD-10 Coding for Shift Work Sleep Disorder(G47.26)
Complete ICD-10-CM coding and documentation guide for Shift Work Sleep Disorder. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Shift Work Sleep Disorder
G47.20-G47.29Primary Range
Circadian Rhythm Sleep Disorders
This range includes disorders related to the body's internal clock, including shift work sleep disorder.
Key Information: ICD-10 code for shift work sleep disorder
Essential facts and insights about Shift Work Sleep Disorder
Primary ICD-10-CM Code for shift work sleep disorder
Decision Criteria
clinical Criteria
- Patient reports insomnia or excessive sleepiness tied to shift work for ≥3 months.
documentation Criteria
- Work schedule and symptom duration must be documented.
Applicable To
- Shift work sleep disorder
Clinical Validation Requirements
- Symptoms persist for at least 3 months
- ESS score ≥10
- Sleep logs or actigraphy showing circadian misalignment
Code-Specific Risks
- Incorrectly coding general insomnia instead of SWSD
- Missing documentation of work schedule
Coding Notes
- Ensure documentation includes work schedule and symptom duration.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Differential Codes
Alternative codes to consider when ruling out similar conditions to the primary diagnosis.
Circadian rhythm sleep disorder, delayed sleep phase type
G47.21Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Shift Work Sleep Disorder to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code G47.26.
Impact
Clinical: Misdiagnosis of sleep disorder type., Regulatory: Non-compliance with ICD-10 coding standards., Financial: Potential claim denials due to insufficient documentation.
Mitigation Strategy
Use templates that prompt for work schedule details., Educate staff on the importance of detailed documentation.
Impact
Reimbursement: Incorrect coding can lead to denied claims., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate data on sleep disorder prevalence.
Mitigation Strategy
Link insomnia to work schedule; code G47.26 first.
Impact
Lack of detailed work schedule documentation can trigger audits.
Mitigation Strategy
Ensure all patient records include specific work schedule details.
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 Shift Work Sleep Disorder, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Shift Work Sleep Disorder
Use these documentation templates to ensure complete and accurate documentation for Shift Work Sleep Disorder. These templates include all required elements for proper coding and billing.
Shift Work Sleep Disorder in a Nurse
Specialty: Sleep MedicineRequired Elements
- Work schedule
- Symptom duration
- ESS score
- Actigraphy results
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
Need help with ICD-10 coding for Shift Work Sleep Disorder? Ask your questions below.