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ICD-10 Guide
ICD-10 CodesG47.10

G47.10

Billable

Hypersomnia, unspecified

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

Code Description

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

Key Diagnostic Point:

Hypersomnia is characterized by excessive daytime sleepiness that is not attributable to other sleep disorders or medical conditions. Patients may experience prolonged nighttime sleep or recurrent episodes of sleep during the day, which can significantly impair their daily functioning. The condition can arise from various underlying causes, including sleep apnea, narcolepsy, or other sleep disorders, but when unspecified, it indicates that the exact etiology has not been determined. Diagnosis typically involves a thorough clinical evaluation, including sleep history, physical examination, and possibly polysomnography or other sleep studies to rule out other conditions. Treatment may include lifestyle modifications, pharmacotherapy, or addressing any underlying conditions contributing to the hypersomnia. Accurate coding is essential for proper management and reimbursement, as hypersomnia can overlap with other sleep disorders, making precise documentation critical for distinguishing between them.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between hypersomnia and other sleep disorders like sleep apnea and narcolepsy.
  • Need for comprehensive patient history and sleep study results.
  • Potential overlap with other ICD-10 codes related to sleep disorders.
  • Variability in symptoms and patient reporting.

Audit Risk Factors

  • Inadequate documentation of symptoms and patient history.
  • Failure to perform or document sleep studies.
  • Misclassification of hypersomnia as insomnia or other sleep disorders.
  • Lack of follow-up documentation to support ongoing treatment.

Specialty Focus

Medical Specialties

Sleep Medicine

Documentation Requirements

Detailed sleep history, results from polysomnography, and any comorbid conditions.

Common Clinical Scenarios

Patients presenting with excessive daytime sleepiness, fatigue, and difficulty concentrating.

Billing Considerations

Ensure all relevant sleep studies are documented and interpreted correctly.

Neurology

Documentation Requirements

Neurological examination findings, history of sleep patterns, and any neurological conditions.

Common Clinical Scenarios

Patients with suspected narcolepsy or other neurological conditions affecting sleep.

Billing Considerations

Document any neurological assessments that may contribute to the diagnosis.

Coding Guidelines

Inclusion Criteria

Use G47.10 When
  • According to the ICD
  • CM guidelines, G47
  • 10 should be used when hypersomnia is diagnosed but the specific cause is not identified
  • It is important to document any relevant history or findings that may assist in future coding or treatment decisions

Exclusion Criteria

Do NOT use G47.10 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

95810CPT Code

Polysomnography, sleep study

Clinical Scenario

Used to diagnose sleep disorders including hypersomnia.

Documentation Requirements

Document the indication for the sleep study and results.

Specialty Considerations

Sleep specialists should ensure comprehensive interpretation of results.

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 hypersomnia. This has improved the ability to capture the complexity of sleep-related conditions and has enhanced the accuracy of billing and reimbursement processes.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of sleep disorders, including hypersomnia. This has improved the ability to capture the complexity of sleep-related conditions and has enhanced the accuracy of billing and reimbursement processes.

Reimbursement & Billing Impact

billing and reimbursement processes.

Resources

Clinical References

  • •
    American Academy of Sleep Medicine

Coding & Billing References

  • •
    American Academy of Sleep Medicine

Frequently Asked Questions

What is the difference between hypersomnia and narcolepsy?

Hypersomnia refers to excessive daytime sleepiness without a specific cause, while narcolepsy is a specific sleep disorder characterized by recurrent episodes of irresistible sleep and often includes cataplexy.