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ICD-10 Guide
ICD-10 CodesG47.31

G47.31

Billable

Primary central sleep apnea

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

Code Description

ICD-10 G47.31 is a billable code used to indicate a diagnosis of primary central sleep apnea.

Key Diagnostic Point:

Primary central sleep apnea (CSA) is a sleep disorder characterized by recurrent episodes of apnea due to a lack of respiratory effort during sleep. Unlike obstructive sleep apnea, where airflow is obstructed despite respiratory effort, CSA occurs when the brain fails to send appropriate signals to the muscles that control breathing. This condition can manifest in various forms, including idiopathic CSA, which has no identifiable cause, and CSA associated with other medical conditions such as heart failure or stroke. Patients with CSA often experience disrupted sleep patterns, leading to excessive daytime sleepiness, fatigue, and impaired cognitive function. Diagnosis typically involves polysomnography (sleep study), which records brain waves, oxygen levels, heart rate, and breathing patterns during sleep. Treatment options may include adaptive servo-ventilation (ASV), bilevel positive airway pressure (BiPAP), or supplemental oxygen, depending on the severity and underlying causes. Understanding the nuances of CSA is crucial for accurate diagnosis and effective management.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between central and obstructive sleep apnea
  • Need for comprehensive sleep study interpretation
  • Potential overlap with other sleep disorders
  • Variability in clinical presentation

Audit Risk Factors

  • Inadequate documentation of sleep study results
  • Failure to specify the type of sleep apnea
  • Misclassification of central vs. obstructive apnea
  • Lack of documentation for associated conditions

Specialty Focus

Medical Specialties

Pulmonology

Documentation Requirements

Detailed sleep study results, clinical history, and treatment plans.

Common Clinical Scenarios

Patients presenting with excessive daytime sleepiness, fatigue, or cognitive impairment.

Billing Considerations

Ensure clear differentiation between central and obstructive sleep apnea in documentation.

Neurology

Documentation Requirements

Neurological assessments, history of neurological conditions, and sleep study interpretations.

Common Clinical Scenarios

Patients with neurological disorders presenting with sleep disturbances.

Billing Considerations

Document any neurological conditions that may contribute to CSA.

Coding Guidelines

Inclusion Criteria

Use G47.31 When
  • According to ICD
  • 10 coding guidelines, G47
  • 31 should be used when the primary diagnosis is central sleep apnea without any associated conditions
  • It is essential to document the results of polysomnography and any relevant clinical history

Exclusion Criteria

Do NOT use G47.31 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

95810CPT Code

Polysomnography, sleep study

Clinical Scenario

Used to diagnose primary central sleep apnea through comprehensive sleep monitoring.

Documentation Requirements

Results of the sleep study must be documented, including apnea-hypopnea index (AHI) and oxygen saturation levels.

Specialty Considerations

Pulmonologists and sleep specialists should ensure accurate interpretation of sleep study data.

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 primary central sleep apnea, which enhances the ability to track and manage these conditions more effectively.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of sleep disorders, including primary central sleep apnea, which enhances the ability to track and manage these conditions more effectively.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of sleep disorders, including primary central sleep apnea, which enhances the ability to track and manage these conditions more effectively.

Resources

Clinical References

  • •
    American Academy of Sleep Medicine

Coding & Billing References

  • •
    American Academy of Sleep Medicine

Frequently Asked Questions

What is the difference between primary central sleep apnea and obstructive sleep apnea?

Primary central sleep apnea occurs due to a lack of respiratory effort, while obstructive sleep apnea is caused by physical blockage of the airway. Diagnosis is confirmed through sleep studies that differentiate between the two.