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ICD-10 Guide
ICD-10 CodesG47.00

G47.00

Billable

Insomnia, unspecified

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

Code Description

ICD-10 G47.00 is a billable code used to indicate a diagnosis of insomnia, unspecified.

Key Diagnostic Point:

Insomnia is a sleep disorder characterized by difficulty falling asleep, staying asleep, or waking up too early and not being able to return to sleep. The condition can lead to daytime fatigue, mood disturbances, and impaired functioning. Insomnia can be classified as acute or chronic, with chronic insomnia lasting for at least three times a week for three months or longer. The causes of insomnia can be multifactorial, including psychological factors such as anxiety and depression, medical conditions, medications, and lifestyle choices. Insomnia is often associated with other sleep disorders, such as sleep apnea, where breathing interruptions during sleep can exacerbate insomnia symptoms. Diagnosis typically involves a thorough clinical evaluation, including sleep history, sleep patterns, and possibly a sleep study (polysomnography) to rule out other sleep disorders. Treatment may include cognitive behavioral therapy for insomnia (CBT-I), lifestyle modifications, and pharmacotherapy. Accurate coding for insomnia is crucial for appropriate treatment and reimbursement, as it can significantly impact a patient's quality of life and overall health.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variety of potential underlying causes
  • Overlap with other sleep disorders
  • Need for comprehensive patient history
  • Variability in treatment approaches

Audit Risk Factors

  • Insufficient documentation of symptoms
  • Lack of differentiation from other sleep disorders
  • Inadequate patient history
  • Failure to document treatment response

Specialty Focus

Medical Specialties

Sleep Medicine

Documentation Requirements

Detailed sleep history, results of sleep studies, and treatment plans.

Common Clinical Scenarios

Patients presenting with chronic insomnia, referrals for sleep studies, and management of comorbid sleep disorders.

Billing Considerations

Ensure clear documentation of the insomnia type and any associated conditions.

Psychiatry

Documentation Requirements

Mental health evaluations, treatment plans, and medication management.

Common Clinical Scenarios

Patients with insomnia linked to anxiety or depression, medication side effects, and therapy outcomes.

Billing Considerations

Document the relationship between mental health conditions and insomnia.

Coding Guidelines

Inclusion Criteria

Use G47.00 When
  • Follow the official ICD
  • CM coding guidelines, ensuring that the code is used when insomnia is documented without a specified cause

Exclusion Criteria

Do NOT use G47.00 When
  • Exclude codes for insomnia due to other mental or medical disorders

Related ICD-10 Codes

Related CPT Codes

95810CPT Code

Polysomnography

Clinical Scenario

Used to evaluate patients with suspected sleep disorders, including insomnia.

Documentation Requirements

Document the indication 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, improving the ability to capture the complexity of insomnia and its associated conditions.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of sleep disorders, improving the ability to capture the complexity of insomnia and its associated conditions.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of sleep disorders, improving the ability to capture the complexity of insomnia and its associated conditions.

Resources

Clinical References

  • •
    American Academy of Sleep Medicine

Coding & Billing References

  • •
    American Academy of Sleep Medicine

Frequently Asked Questions

When should I use G47.00?

Use G47.00 when insomnia is documented without a specified cause, and ensure that other sleep disorders are ruled out.