Back to HomeBeta

ICD-10 Coding for Sleepiness(G47.11, R40.0)

Complete ICD-10-CM coding and documentation guide for Sleepiness. Includes clinical validation requirements, documentation requirements, and coding pitfalls.

Also known as:

Excessive Daytime SleepinessHypersomnia

Quick Navigation

Related ICD-10 Code Ranges

Complete code families applicable to Sleepiness

G47.10-G47.19Primary Range

Hypersomnia not due to a substance or known physiological condition

This range includes codes for idiopathic hypersomnia and related conditions.

R40.0

Somnolence

Used for excessive daytime sleepiness without a confirmed diagnosis.

Z72.820-Z72.821

Sleep-related issues

Ancillary codes for sleep deprivation and inadequate sleep hygiene.

Code Comparison: When to Use Each Code

Compare key differences between these codes to ensure accurate selection

CodeDescriptionWhen to UseKey Documentation
G47.11Idiopathic hypersomnia with long sleep timeUse when idiopathic hypersomnia is confirmed with long sleep time.
  • MSLT: Mean sleep latency ≤8 min, <2 SOREMPs
  • PSG rules out OSA (AHI <5)
R40.0SomnolenceUse when excessive daytime sleepiness is present without a confirmed diagnosis.
  • Patient reports persistent daytime sleepiness ≥3 months
  • Epworth Score: 16/24

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 sleepiness

Essential facts and insights about Sleepiness

The ICD-10 code for excessive daytime sleepiness without a confirmed diagnosis is R40.0. For idiopathic hypersomnia, use G47.11.

Primary ICD-10-CM Codes for sleepiness

G47.11
Idiopathic hypersomnia with long sleep time
Billable Code

Decision Criteria

clinical Criteria

  • Confirmed idiopathic hypersomnia with long sleep time.

Applicable To

  • Idiopathic hypersomnia with long sleep time

Excludes

  • Hypersomnia due to a substance (F13.182)

Clinical Validation Requirements

  • MSLT: Mean sleep latency ≤8 min, <2 SOREMPs
  • PSG rules out OSA (AHI <5)

Code-Specific Risks

  • Requires PSG and MSLT for validation.

Coding Notes

  • Ensure documentation supports idiopathic hypersomnia diagnosis.
View Full Code Details

Ancillary Codes

Additional codes that should be used in conjunction with the main diagnosis codes when applicable.

Sleep deprivation

Z72.820
Use as secondary if sleep deprivation impacts care.

Differential Codes

Alternative codes to consider when ruling out similar conditions to the primary diagnosis.

Obstructive sleep apnea (adult) (pediatric)

G47.33
Use G47.33 when PSG confirms AHI ≥5.

Idiopathic hypersomnia with long sleep time

G47.11
Use G47.11 when idiopathic hypersomnia is confirmed.

Documentation & Coding Risks

Avoid these common documentation and coding issues when documenting Sleepiness to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code G47.11.

Impact

Clinical: Inadequate understanding of patient's condition., Regulatory: Non-compliance with documentation standards., Financial: Potential for claim denials.

Mitigation Strategy

Ensure thorough sleep history is documented., Use standardized sleep assessment tools.

Impact

Reimbursement: May lead to denial for lack of medical necessity., Compliance: Non-compliance with documentation standards., Data Quality: Inaccurate representation of patient's condition.

Mitigation Strategy

Include quantitative data like Epworth Score and frequency of symptoms.

Impact

Failure to provide sufficient documentation for sleep disorders.

Mitigation Strategy

Ensure comprehensive documentation including quantitative measures and diagnostic test results.

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 Sleepiness, with expert answers to help guide accurate code selection and documentation.

Documentation Templates for Sleepiness

Use these documentation templates to ensure complete and accurate documentation for Sleepiness. These templates include all required elements for proper coding and billing.

Patient presenting with excessive daytime sleepiness

Specialty: Sleep Medicine

Required Elements

  • Epworth Score
  • Sleep history
  • PSG and MSLT results

Example Documentation

Patient reports daily Epworth Score 18/24 ×4 months, with unintended sleep episodes during meetings (≥3×/week). MSLT: Mean latency 6.2 min, 0 SOREMPs. PSG: AHI 2.5, SpO2 94-97%.

Examples: Poor vs. Good Documentation

Poor Documentation Example
Patient complains of tiredness.
Good Documentation Example
Patient endorses daily Epworth Score 18/24 ×4 months, with unintended sleep episodes during meetings (≥3×/week).
Explanation
The good example provides specific, quantifiable data supporting the diagnosis.

Need help with ICD-10 coding for Sleepiness? Ask your questions below.

Ask about any ICD-10 CM code, or paste a medical note

We build tools for
clinician happiness.

Learn More at Freed.ai
Back to HomeBeta

Built by Freed

Try Freed for free for 7 days.

Learn more

Helpful Links

How ICD 10 AI Lookup WorksContact UsPrivacy Policy