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ICD-10 Guide
ICD-10 CodesG47.19

G47.19

Billable

Other hypersomnia

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

Code Description

ICD-10 G47.19 is a billable code used to indicate a diagnosis of other hypersomnia.

Key Diagnostic Point:

Other hypersomnia encompasses a range of sleep disorders characterized by excessive daytime sleepiness not attributed to other specific sleep disorders such as narcolepsy or sleep apnea. Patients may experience prolonged sleep episodes, difficulty waking, and an overwhelming need to sleep during the day. This condition can significantly impact daily functioning, leading to decreased productivity, impaired cognitive function, and increased risk of accidents. The etiology of other hypersomnia can vary, including genetic factors, psychiatric conditions, and other medical disorders. Diagnosis typically involves a thorough clinical evaluation, including sleep history, physical examination, and may require polysomnography or multiple sleep latency tests to rule out other sleep disorders. Treatment options may include lifestyle modifications, pharmacotherapy, and addressing any underlying conditions contributing to excessive sleepiness. Accurate diagnosis and coding are crucial for effective management and reimbursement.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between various types of hypersomnia
  • Need for comprehensive sleep study interpretation
  • Potential overlap with other sleep disorders like narcolepsy and sleep apnea
  • Variability in patient presentation and underlying causes

Audit Risk Factors

  • Inadequate documentation of sleep study results
  • Failure to specify the type of hypersomnia
  • Misdiagnosis due to overlapping symptoms with other sleep disorders
  • Lack of evidence for treatment plans

Specialty Focus

Medical Specialties

Sleep Medicine

Documentation Requirements

Detailed sleep history, results of polysomnography, and treatment plans.

Common Clinical Scenarios

Patients presenting with excessive daytime sleepiness, fatigue, and difficulty concentrating.

Billing Considerations

Ensure comprehensive documentation of all sleep studies and any comorbid conditions.

Neurology

Documentation Requirements

Neurological evaluations, history of symptoms, and any relevant imaging studies.

Common Clinical Scenarios

Patients with neurological conditions presenting with hypersomnia symptoms.

Billing Considerations

Document any neurological assessments that may contribute to the diagnosis.

Coding Guidelines

Inclusion Criteria

Use G47.19 When
  • Follow official ICD
  • 10 guidelines for coding sleep disorders, ensuring to document the specific type of hypersomnia and any relevant comorbidities

Exclusion Criteria

Do NOT use G47.19 When
  • Exclude conditions that are specifically defined in other codes

Related ICD-10 Codes

Related CPT Codes

95810CPT Code

Polysomnography, sleep study

Clinical Scenario

Used to diagnose sleep disorders including hypersomnia.

Documentation Requirements

Document the reason 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, improving the accuracy of diagnoses and treatment plans. G47.19 provides a distinct code for hypersomnia that was less clearly defined in ICD-9.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of sleep disorders, improving the accuracy of diagnoses and treatment plans. G47.19 provides a distinct code for hypersomnia that was less clearly defined in ICD-9.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of sleep disorders, improving the accuracy of diagnoses and treatment plans. G47.19 provides a distinct code for hypersomnia that was less clearly defined in ICD-9.

Resources

Clinical References

  • •
    American Academy of Sleep Medicine

Coding & Billing References

  • •
    American Academy of Sleep Medicine

Frequently Asked Questions

What is the difference between G47.19 and G47.10?

G47.19 refers to other hypersomnia not classified as narcolepsy, while G47.10 specifically refers to narcolepsy with cataplexy, which has distinct diagnostic criteria.