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ICD-10 Guide
ICD-10 CodesG47.33

G47.33

Billable

Obstructive sleep apnea (adult) (pediatric)

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

Code Description

ICD-10 G47.33 is a billable code used to indicate a diagnosis of obstructive sleep apnea (adult) (pediatric).

Key Diagnostic Point:

Obstructive sleep apnea (OSA) is a common sleep disorder characterized by repeated interruptions in breathing during sleep due to the relaxation of throat muscles and tissues. This condition can occur in both adults and children, leading to fragmented sleep and decreased oxygen levels in the blood. Symptoms often include loud snoring, gasping or choking during sleep, excessive daytime sleepiness, and difficulty concentrating. In adults, OSA is associated with various comorbidities such as hypertension, cardiovascular disease, and metabolic syndrome. In pediatric patients, it may present differently, often manifesting as behavioral issues, poor academic performance, or growth problems. Diagnosis typically involves a sleep study (polysomnography) to monitor sleep patterns, breathing, and oxygen levels. Treatment options include lifestyle changes, continuous positive airway pressure (CPAP) therapy, oral appliances, and in some cases, surgical interventions. Accurate coding of OSA is crucial for appropriate management and reimbursement.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between adult and pediatric cases
  • Variability in symptoms and presentation across age groups
  • Need for comprehensive sleep study interpretation
  • Potential for comorbid conditions affecting coding

Audit Risk Factors

  • Inadequate documentation of sleep study results
  • Failure to specify whether the patient is adult or pediatric
  • Lack of evidence for comorbid conditions
  • Improper linkage of diagnosis to treatment provided

Specialty Focus

Medical Specialties

Sleep Medicine

Documentation Requirements

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

Common Clinical Scenarios

Patients presenting with excessive daytime sleepiness, snoring, or behavioral issues in children.

Billing Considerations

Ensure clear documentation of the severity of OSA and any associated comorbidities.

Pulmonology

Documentation Requirements

Comprehensive respiratory assessments and follow-up treatment plans.

Common Clinical Scenarios

Patients with chronic respiratory conditions exacerbated by OSA.

Billing Considerations

Document any pulmonary function tests and their relation to sleep apnea.

Coding Guidelines

Inclusion Criteria

Use G47.33 When
  • Follow the official ICD
  • CM coding guidelines, ensuring accurate documentation of the patient's age, symptoms, and results from sleep studies
  • Include any relevant comorbidities that may affect treatment

Exclusion Criteria

Do NOT use G47.33 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

95810CPT Code

Polysomnography, sleep study

Clinical Scenario

Used to diagnose OSA in patients presenting with sleep disturbances.

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, including the differentiation between adult and pediatric cases of obstructive sleep apnea, improving the accuracy of diagnosis and treatment tracking.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of sleep disorders, including the differentiation between adult and pediatric cases of obstructive sleep apnea, improving the accuracy of diagnosis and treatment tracking.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of sleep disorders, including the differentiation between adult and pediatric cases of obstructive sleep apnea, improving the accuracy of diagnosis and treatment tracking.

Resources

Clinical References

  • •
    American Academy of Sleep Medicine

Coding & Billing References

  • •
    American Academy of Sleep Medicine

Frequently Asked Questions

What is the difference between adult and pediatric obstructive sleep apnea?

Adult OSA typically presents with symptoms like loud snoring and excessive daytime sleepiness, while pediatric OSA may manifest as behavioral issues, poor academic performance, or growth problems. Diagnosis and treatment approaches may also differ.