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ICD-10 Guide
ICD-10 CodesF51.05

F51.05

Billable

Insomnia due to other mental disorder

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

Code Description

ICD-10 F51.05 is a billable code used to indicate a diagnosis of insomnia due to other mental disorder.

Key Diagnostic Point:

Insomnia due to other mental disorders is characterized by difficulty in initiating or maintaining sleep, which is directly attributable to a primary mental health condition. This can include a range of disorders such as anxiety disorders, mood disorders, and eating disorders. In the context of eating disorders, individuals may experience insomnia due to the psychological stress and physiological changes associated with conditions like anorexia nervosa or bulimia nervosa. Sleep disturbances can exacerbate the symptoms of these disorders, creating a vicious cycle. Similarly, sexual dysfunction and behavioral syndromes can lead to insomnia as individuals may experience heightened anxiety or distress, impacting their ability to sleep. The interplay between mental health and sleep is complex, as insomnia can also worsen the underlying mental disorder, making treatment challenging. Clinicians must carefully assess the mental health status of patients presenting with insomnia to ensure accurate diagnosis and effective treatment planning.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between primary insomnia and insomnia secondary to mental disorders.
  • Understanding the interplay between various mental health conditions and sleep disturbances.
  • Documenting the specific mental disorder contributing to insomnia.
  • Navigating the nuances of co-morbid conditions that may affect sleep.

Audit Risk Factors

  • Inadequate documentation of the mental disorder causing insomnia.
  • Failure to link insomnia to the primary diagnosis.
  • Misclassification of insomnia as primary rather than secondary.
  • Lack of comprehensive patient history regarding sleep patterns.

Specialty Focus

Medical Specialties

Psychiatry

Documentation Requirements

Detailed mental health assessments, including history of sleep disturbances and mental disorders.

Common Clinical Scenarios

Patients with anxiety disorders reporting insomnia, individuals with depression experiencing sleep issues.

Billing Considerations

Consideration of medication side effects that may contribute to insomnia.

Sleep Medicine

Documentation Requirements

Sleep studies, detailed sleep history, and correlation with mental health evaluations.

Common Clinical Scenarios

Patients with diagnosed sleep apnea also presenting with anxiety or depression.

Billing Considerations

Need for interdisciplinary collaboration with mental health professionals.

Coding Guidelines

Inclusion Criteria

Use F51.05 When
  • According to ICD
  • 10 guidelines, F51
  • 05 should be used when insomnia is directly linked to another mental disorder
  • Coders must ensure that the primary mental disorder is documented and that insomnia is not coded separately if it is a symptom of the primary condition

Exclusion Criteria

Do NOT use F51.05 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

90834CPT Code

Psychotherapy, 45 minutes

Clinical Scenario

Used for patients with insomnia due to mental disorders requiring therapy.

Documentation Requirements

Document the patient's mental health status and treatment goals.

Specialty Considerations

Psychiatrists should note the relationship between therapy and sleep improvement.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of insomnia related to mental disorders, improving the accuracy of diagnoses and treatment plans. This specificity aids in better understanding the prevalence of insomnia in mental health populations.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of insomnia related to mental disorders, improving the accuracy of diagnoses and treatment plans. This specificity aids in better understanding the prevalence of insomnia in mental health populations.

Reimbursement & Billing Impact

impact of insomnia on their daily life, and the treatment provided. This ensures compliance with payer requirements and supports the medical necessity of services rendered.

Resources

Clinical References

  • •
    ICD-10-CM Official Guidelines for Coding and Reporting

Coding & Billing References

  • •
    ICD-10-CM Official Guidelines for Coding and Reporting

Frequently Asked Questions

What is the difference between F51.05 and F51.01?

F51.05 is used when insomnia is secondary to another mental disorder, while F51.01 is for primary insomnia without any underlying mental health condition.