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ICD-10 Guide
ICD-10 CodesG47.14

G47.14

Billable

Hypersomnia due to medical condition

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

Code Description

ICD-10 G47.14 is a billable code used to indicate a diagnosis of hypersomnia due to medical condition.

Key Diagnostic Point:

Hypersomnia due to medical condition is characterized by excessive daytime sleepiness that is primarily caused by an underlying medical condition. This condition can significantly impact a patient's quality of life and may be associated with various disorders, including neurological conditions, metabolic disorders, and psychiatric illnesses. Common medical conditions that can lead to hypersomnia include hypothyroidism, chronic kidney disease, and certain types of cancer. Patients may present with prolonged sleep episodes, difficulty waking up, and impaired cognitive function. Diagnosis typically involves a thorough clinical evaluation, including a detailed medical history, physical examination, and possibly sleep studies to rule out other sleep disorders such as sleep apnea or narcolepsy. Treatment focuses on managing the underlying medical condition and may include pharmacological interventions, lifestyle modifications, and behavioral therapies. Accurate coding of hypersomnia due to medical conditions is crucial for appropriate reimbursement and to ensure that patients receive the necessary care for their underlying health issues.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between primary hypersomnia and hypersomnia due to a medical condition.
  • Need for comprehensive documentation of the underlying medical condition.
  • Potential overlap with other sleep disorders such as sleep apnea and narcolepsy.
  • Variability in symptoms and severity among patients.

Audit Risk Factors

  • Inadequate documentation of the underlying medical condition.
  • Failure to perform or document sleep studies.
  • Misclassification of hypersomnia as primary rather than secondary.
  • Lack of follow-up documentation to support ongoing treatment.

Specialty Focus

Medical Specialties

Neurology

Documentation Requirements

Detailed neurological examination findings and any relevant imaging studies.

Common Clinical Scenarios

Patients presenting with excessive daytime sleepiness and a history of neurological disorders.

Billing Considerations

Ensure that all neurological conditions are documented and linked to the hypersomnia diagnosis.

Sleep Medicine

Documentation Requirements

Results from polysomnography and other sleep studies, along with a comprehensive sleep history.

Common Clinical Scenarios

Patients undergoing evaluation for sleep disorders who have comorbid medical conditions.

Billing Considerations

Accurate interpretation of sleep study results is crucial for proper coding.

Coding Guidelines

Inclusion Criteria

Use G47.14 When
  • According to ICD
  • 10 coding guidelines, G47
  • 14 should be used when hypersomnia is directly attributable to a medical condition
  • Coders must ensure that the underlying condition is documented and coded appropriately

Exclusion Criteria

Do NOT use G47.14 When
  • Exclusion criteria include primary hypersomnia and hypersomnia due to substance use

Related ICD-10 Codes

Related CPT Codes

95810CPT Code

Polysomnography, sleep study

Clinical Scenario

Used to evaluate patients with suspected sleep disorders, including hypersomnia.

Documentation Requirements

Results of the sleep study must be documented and linked to the diagnosis.

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 hypersomnia due to medical conditions, improving the accuracy of diagnoses and treatment plans. This specificity aids in better patient management and reimbursement processes.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of hypersomnia due to medical conditions, improving the accuracy of diagnoses and treatment plans. This specificity aids in better patient management and reimbursement processes.

Reimbursement & Billing Impact

reimbursement processes.

Resources

Clinical References

  • •
    ICD-10-CM Official Guidelines for Coding and Reporting

Coding & Billing References

  • •
    ICD-10-CM Official Guidelines for Coding and Reporting

Frequently Asked Questions

What is the difference between G47.14 and G47.10?

G47.14 is specifically for hypersomnia due to a medical condition, while G47.10 is used for unspecified hypersomnia. Accurate documentation of the underlying condition is essential for using G47.14.