ICD-10 Coding for Sleep Disordered Breathing(G47.33, G47.31)
Complete ICD-10-CM coding and documentation guide for Sleep Disordered Breathing. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Sleep Disordered Breathing
G47.30-G47.39Primary Range
Sleep Apnea
This range includes codes for different types of sleep apnea, including obstructive, central, and unspecified types.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| G47.33 | Obstructive Sleep Apnea (Adult) (Pediatric) | Use when obstructive sleep apnea is confirmed via sleep study. |
|
| G47.31 | Central Sleep Apnea | Use when central sleep apnea is confirmed and predominant. |
|
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 obstructive sleep apnea
Essential facts and insights about Sleep Disordered Breathing
Primary ICD-10-CM Codes for sleep disordered breathing
Decision Criteria
clinical Criteria
- AHI ≥5 with symptoms or ≥15 without symptoms
Applicable To
- Obstructive sleep apnea syndrome
Clinical Validation Requirements
- Polysomnography or home sleep apnea test showing AHI ≥5 with symptoms or ≥15 without symptoms
Code-Specific Risks
- Confusing with central sleep apnea
- Not documenting AHI or RDI values
Coding Notes
- Ensure documentation includes AHI values and symptoms.
G47.31 - Central Sleep Apnea
Use when central sleep apnea is confirmed and predominant.
Applicable To
- Central sleep apnea syndrome
Excludes
- Obstructive sleep apnea (G47.33)
Clinical Validation Requirements
- Polysomnography showing central apneas ≥5/hour
Coding Notes
Ensure documentation specifies central apnea predominance.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Snoring
R06.83Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Sleep Disordered Breathing to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code G47.33.
Impact
Clinical: Inaccurate diagnosis confirmation., Regulatory: Potential audit issues., Financial: Claim denials due to insufficient documentation.
Mitigation Strategy
Ensure AHI values are included in all sleep study reports., Cross-check documentation before submission.
Impact
Reimbursement: Incorrect coding can lead to claim denials., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate patient records and statistics.
Mitigation Strategy
Verify the type of apnea through sleep study results.
Impact
Failure to document AHI can lead to audit flags.
Mitigation Strategy
Ensure all sleep studies include AHI and related symptoms.
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 Sleep Disordered Breathing, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Sleep Disordered Breathing
Use these documentation templates to ensure complete and accurate documentation for Sleep Disordered Breathing. These templates include all required elements for proper coding and billing.
OSA Diagnosis
Specialty: PulmonologyRequired Elements
- Patient symptoms
- AHI values
- Comorbid conditions
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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