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ICD-10 Guide
ICD-10 CodesG47.13

G47.13

Billable

Recurrent hypersomnia

BILLABLE STATUSYes
IMPLEMENTATION DATEOctober 1, 2015
LAST UPDATED09/05/2025

Code Description

ICD-10 G47.13 is a billable code used to indicate a diagnosis of recurrent hypersomnia.

Key Diagnostic Point:

Recurrent hypersomnia is characterized by excessive daytime sleepiness and prolonged sleep episodes that occur repeatedly over time. Patients may experience episodes of excessive sleep lasting from several days to weeks, often following a period of normal sleep patterns. This condition can significantly impact daily functioning, leading to difficulties in work, social interactions, and overall quality of life. The etiology of recurrent hypersomnia can be multifactorial, including genetic predispositions, environmental factors, and underlying medical conditions. It is essential to differentiate recurrent hypersomnia from other sleep disorders such as narcolepsy, sleep apnea, and idiopathic hypersomnia, as the management and treatment strategies may differ. Diagnosis typically involves a thorough clinical evaluation, sleep history, and may include polysomnography or multiple sleep latency tests to assess sleep architecture and daytime sleepiness. Treatment options may include lifestyle modifications, stimulant medications, and addressing any underlying conditions contributing to the hypersomnia.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiation from other sleep disorders like narcolepsy and sleep apnea.
  • Need for comprehensive sleep history and potential sleep study results.
  • Variability in symptoms and presentation among patients.
  • Potential overlap with psychiatric conditions such as depression.

Audit Risk Factors

  • Inadequate documentation of recurrent episodes.
  • Failure to differentiate from other sleep disorders.
  • Lack of supporting evidence from sleep studies.
  • Insufficient clinical correlation between symptoms and diagnosis.

Specialty Focus

Medical Specialties

Sleep Medicine

Documentation Requirements

Detailed sleep history, results from polysomnography, and clinical assessments.

Common Clinical Scenarios

Patients presenting with excessive daytime sleepiness, prolonged sleep episodes, and difficulty functioning.

Billing Considerations

Ensure clear documentation of recurrent episodes and any comorbid conditions.

Neurology

Documentation Requirements

Neurological evaluations, history of sleep patterns, and any neurological assessments.

Common Clinical Scenarios

Patients with neurological conditions presenting with hypersomnia symptoms.

Billing Considerations

Document any neurological findings that may contribute to hypersomnia.

Coding Guidelines

Inclusion Criteria

Use G47.13 When
  • Follow the official ICD
  • CM coding guidelines for sleep disorders
  • Ensure accurate documentation of symptoms, duration, and impact on daily life
  • Include results from sleep studies when applicable

Exclusion Criteria

Do NOT use G47.13 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

95810CPT Code

Polysomnography, sleep study

Clinical Scenario

Used to evaluate sleep architecture in patients with recurrent hypersomnia.

Documentation Requirements

Document the indication for the sleep study and results.

Specialty Considerations

Sleep specialists should ensure comprehensive reporting of findings.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of sleep disorders, including recurrent hypersomnia, which enhances the ability to capture the complexity of these conditions and improve patient care.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of sleep disorders, including recurrent hypersomnia, which enhances the ability to capture the complexity of these conditions and improve patient care.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of sleep disorders, including recurrent hypersomnia, which enhances the ability to capture the complexity of these conditions and improve patient care.

Resources

Clinical References

  • •
    American Academy of Sleep Medicine

Coding & Billing References

  • •
    American Academy of Sleep Medicine

Frequently Asked Questions

What are the common symptoms of recurrent hypersomnia?

Common symptoms include excessive daytime sleepiness, prolonged sleep episodes, and difficulty waking up after sleep. Patients may also experience cognitive impairments and mood disturbances.