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ICD-10 Guide
ICD-10 CodesG47.30

G47.30

Billable

Sleep apnea, unspecified

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

Code Description

ICD-10 G47.30 is a billable code used to indicate a diagnosis of sleep apnea, unspecified.

Key Diagnostic Point:

Sleep apnea is a sleep disorder characterized by repeated interruptions in breathing during sleep. These interruptions can last from a few seconds to minutes and may occur 30 times or more an hour. The condition can lead to fragmented sleep and low blood oxygen levels, resulting in excessive daytime sleepiness, fatigue, and other health complications. The unspecified designation indicates that the specific type of sleep apnea (obstructive, central, or complex) has not been determined. Patients may present with symptoms such as loud snoring, gasping for air during sleep, and difficulty concentrating during the day. Diagnosis typically involves a sleep study (polysomnography) to monitor breathing patterns, oxygen levels, and other physiological parameters during sleep. Treatment options vary based on the severity and type of sleep apnea and may include lifestyle changes, CPAP therapy, or surgical interventions. Accurate coding is essential for proper treatment and reimbursement, as sleep apnea can significantly impact a patient's quality of life and overall health.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in symptoms and severity among patients
  • Need for comprehensive sleep study results for accurate diagnosis
  • Differentiation between types of sleep apnea
  • Potential overlap with other sleep disorders

Audit Risk Factors

  • Inadequate documentation of sleep study results
  • Failure to specify type of sleep apnea when known
  • Lack of supporting clinical evidence for diagnosis
  • Improper linkage of diagnosis to treatment codes

Specialty Focus

Medical Specialties

Pulmonology

Documentation Requirements

Detailed sleep study results, patient history, and treatment plans must be documented.

Common Clinical Scenarios

Patients presenting with excessive daytime sleepiness, loud snoring, or observed apneas.

Billing Considerations

Ensure that all relevant diagnostic tests are documented to support the diagnosis.

Sleep Medicine

Documentation Requirements

Comprehensive evaluation reports, including polysomnography and clinical assessments.

Common Clinical Scenarios

Patients undergoing evaluation for sleep disorders, including sleep apnea.

Billing Considerations

Documentation must clearly differentiate between types of sleep apnea when applicable.

Coding Guidelines

Inclusion Criteria

Use G47.30 When
  • According to ICD
  • 10 coding guidelines, G47
  • 30 should be used when the specific type of sleep apnea is not documented
  • Coders should ensure that the diagnosis is supported by clinical documentation and that any related conditions are also coded appropriately

Exclusion Criteria

Do NOT use G47.30 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

95810CPT Code

Polysomnography, sleep study

Clinical Scenario

Used to diagnose sleep apnea and other sleep disorders.

Documentation Requirements

Complete sleep study report and interpretation.

Specialty Considerations

Pulmonologists and sleep specialists should ensure comprehensive documentation 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 sleep apnea. G47.30 serves as a catch-all for unspecified cases, but coders must ensure that they are using the most accurate code available based on the documentation.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of sleep disorders, including sleep apnea. G47.30 serves as a catch-all for unspecified cases, but coders must ensure that they are using the most accurate code available based on the documentation.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of sleep disorders, including sleep apnea. G47.30 serves as a catch-all for unspecified cases, but coders must ensure that they are using the most accurate code available based on the documentation.

Resources

Clinical References

  • •
    American Academy of Sleep Medicine

Coding & Billing References

  • •
    American Academy of Sleep Medicine

Frequently Asked Questions

What should I document to support the use of G47.30?

Document the patient's symptoms, results of any sleep studies, and any treatments initiated. Ensure that the documentation reflects the unspecified nature of the diagnosis.