星空入口

Question: When a patient suffers from sleep apnea, how do I choose the correct ICD-10-CM code? I have an encounter form in front of me that says the patient suffers from 鈥渟leep apnea.鈥� Is this all the information I鈥檒l need to choose an accurate diagnosis code?

Nebraska Subscriber

Answer: Probably not. There are many different types of sleep apnea, as evidenced by the number of codes in the G47.3- (Sleep apnea) set. The most general code is G47.30 (Sleep apnea, unspecified), which you鈥檇 use if the neurologist lists a generic diagnosis like 鈥渟leep apnea,鈥� as yours did.

You should, however, query the physician and try to get more information when presented with a situation like the one above; if you can, you鈥檒l be able to choose one of the more specific sleep apnea codes. And some of the sleep apnea codes don鈥檛 even contain the words 鈥渟leep apnea,鈥� so more input from the neurologist is recommended.

Then, you could choose from the following ICD-10-CM codes:

• G47.31 (Primary central sleep apnea). This condition might also be referred to as 鈥渋diopathic central sleep apnea.鈥�
• G47.32 (High altitude periodic breathing)
• G47.33 (Obstructive sleep apnea (adult) (pediatric)). This condition might also be referred to as 鈥渙bstructive sleep apnea hypopnea.鈥� It excludes obstructive sleep apnea in newborns, which you鈥檇 report with P28.3- (Primary sleep apnea of newborn).
• G47.34 (Idiopathic sleep related nonobstructive alveolar hypoventilation). This condition might also be referred to as 鈥渟leep-related hypoxia.鈥�
• G47.35 (Congenital central alveolar hypoventilation syndrome)
• G47.36 (Sleep related hypoventilation in conditions classified elsewhere). When reporting this code, ICD-10 instructs you to 鈥淐ode first underlying condition.鈥�
• G47.37 (Central sleep apnea in conditions classified elsewhere). When reporting this code, ICD-10 instructs you to 鈥淐ode first underlying condition.鈥�
• G47.39 (Other sleep apnea). Report this code if the neurologist names the type of sleep apnea, but you cannot line it up with any of the codes listed above. You might be tempted to use G47.30 in this instance, but that code is only for sleep apnea that hasn鈥檛 been named or specified.
• G47.39 (Other sleep apnea). Report this code when the neurologist lists a specific type of sleep apnea, but it cannot be accounted for with any of the other sleep apnea codes.

Chris Boucher, MS, CPC, Senior Development Editor, AAPC