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ICD-10 Guide
ICD-10 CodesG47.36

G47.36

Billable

Sleep related hypoventilation in conditions classified elsewhere

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

Code Description

ICD-10 G47.36 is a billable code used to indicate a diagnosis of sleep related hypoventilation in conditions classified elsewhere.

Key Diagnostic Point:

Sleep related hypoventilation refers to a condition where an individual experiences inadequate ventilation during sleep, leading to elevated carbon dioxide levels and decreased oxygen levels. This condition is often secondary to other underlying medical issues, such as neuromuscular disorders, obesity hypoventilation syndrome, or central nervous system disorders. Patients may present with symptoms such as excessive daytime sleepiness, fatigue, and cognitive impairment. Diagnosis typically involves polysomnography (sleep study), which can reveal hypoventilation patterns, oxygen desaturation, and abnormal respiratory events during sleep. Treatment may include non-invasive ventilation, weight management, or addressing the underlying condition. Accurate coding is essential for proper reimbursement and to reflect the complexity of the patient's condition.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Requires understanding of underlying conditions that may cause hypoventilation.
  • Differentiation from other sleep disorders like obstructive sleep apnea.
  • Need for comprehensive documentation of sleep study results.
  • Potential overlap with other ICD-10 codes related to sleep disorders.

Audit Risk Factors

  • Inadequate documentation of the underlying condition.
  • Failure to include results from sleep studies.
  • Misclassification of the type of hypoventilation.
  • Lack of clear linkage between symptoms and the diagnosis.

Specialty Focus

Medical Specialties

Pulmonology

Documentation Requirements

Detailed documentation of respiratory function tests, sleep study results, and treatment plans.

Common Clinical Scenarios

Patients with obesity hypoventilation syndrome or neuromuscular disorders presenting with sleep-related breathing issues.

Billing Considerations

Ensure that the underlying condition is well-documented to support the use of G47.36.

Neurology

Documentation Requirements

Comprehensive neurological assessments and documentation of any central nervous system disorders contributing to hypoventilation.

Common Clinical Scenarios

Patients with conditions like amyotrophic lateral sclerosis (ALS) or multiple sclerosis (MS) experiencing sleep-related hypoventilation.

Billing Considerations

Document neurological evaluations and their correlation with sleep studies.

Coding Guidelines

Inclusion Criteria

Use G47.36 When
  • According to ICD
  • 10 guidelines, G47
  • 36 should be used when hypoventilation is documented as related to another condition
  • Coders must ensure that the primary diagnosis is clearly stated and supported by clinical documentation

Exclusion Criteria

Do NOT use G47.36 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

95810CPT Code

Polysomnography

Clinical Scenario

Used to diagnose sleep-related hypoventilation.

Documentation Requirements

Results of the sleep study must be documented in the patient's medical record.

Specialty Considerations

Pulmonologists and 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-related disorders, improving the accuracy of diagnoses and treatment plans. G47.36 provides a clear distinction for hypoventilation related to other conditions, enhancing clinical understanding and reimbursement processes.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of sleep-related disorders, improving the accuracy of diagnoses and treatment plans. G47.36 provides a clear distinction for hypoventilation related to other conditions, enhancing clinical understanding and reimbursement processes.

Reimbursement & Billing Impact

reimbursement processes.

Resources

Clinical References

  • •
    American Academy of Sleep Medicine

Coding & Billing References

  • •
    American Academy of Sleep Medicine

Frequently Asked Questions

What is the primary cause of sleep-related hypoventilation?

Sleep-related hypoventilation can be caused by various underlying conditions, including obesity, neuromuscular disorders, and central nervous system diseases that impair respiratory function during sleep.