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G47.10
ICD-10-CM
Hypersomnia

Understand hypersomnia diagnosis, symptoms, and treatment. Find information on hypersomnia ICD-10 code (G47.1), clinical documentation requirements, differential diagnosis, and comorbid conditions. Explore resources for healthcare professionals, including medical coding guidelines, sleep study interpretation, and best practices for managing excessive daytime sleepiness. Learn about hypersomnia causes, including idiopathic hypersomnia, narcolepsy, and other sleep disorders, and discover effective strategies for patient care and improved sleep health.

Also known as

Excessive Daytime Sleepiness
Idiopathic Hypersomnia

Diagnosis Snapshot

Key Facts
  • Definition : Excessive daytime sleepiness despite adequate sleep duration.
  • Clinical Signs : Difficulty waking up, prolonged sleep episodes, daytime naps, cognitive impairment.
  • Common Settings : Sleep clinics, primary care, neurology, pulmonology (for sleep-related breathing disorders).

Related ICD-10 Code Ranges

Complete code families applicable to AAPC G47.10 Coding
G47.10-G47.19

Hypersomnolence NOS

Excessive sleepiness without a known cause.

G47.410-G47.419

Narcolepsy with cataplexy

Narcolepsy combined with sudden muscle weakness.

G47.400-G47.409

Narcolepsy without cataplexy

Narcolepsy characterized by excessive daytime sleepiness.

F51.1-F51.2

Nonorganic hypersomnia

Excessive sleepiness due to psychological factors.

Code-Specific Guidance

Decision Tree for

Follow this step-by-step guide to choose the correct ICD-10 code.

Is hypersomnia due to a medical condition?

  • Yes

    Specific medical condition documented?

  • No

    Is it due to a substance or medication?

Code Comparison

Related Codes Comparison

When to use each related code

Description
Excessive daytime sleepiness
Narcolepsy
Idiopathic hypersomnia

Documentation Best Practices

Documentation Checklist
  • Hypersomnia diagnosis requires documented excessive daytime sleepiness.
  • Document Epworth Sleepiness Scale score and impact on daily life.
  • Rule out other sleep disorders, medical or psychiatric conditions.
  • Detail sleep study findings (polysomnography, MSLT) if conducted.
  • Document treatment plan, including medications and lifestyle changes.

Coding and Audit Risks

Common Risks
  • Unspecified Hypersomnia

    Coding G47.10 (Unspecified hypersomnia) without sufficient documentation specifying other causes can lead to denials and lost revenue.

  • Comorbidity Overlooked

    Failing to code related conditions like sleep apnea or depression alongside hypersomnia can impact risk adjustment and reimbursement.

  • Insufficient Documentation

    Lack of detailed clinical documentation supporting the diagnosis of hypersomnia exposes claims to audits and potential fraud investigations.

Mitigation Tips

Best Practices
  • Document sleep study (polysomnography) findings for ICD-10 G47.10 accurate coding.
  • Rule out medical causes (e.g., hypothyroidism) impacting Hypersomnia diagnosis G47.10.
  • CDI: Query physician for Hypersomnia severity to support medical necessity, ensure compliance.
  • Track Epworth Sleepiness Scale (ESS) score to monitor Hypersomnia & treatment efficacy.
  • Detailed sleep diary improves Hypersomnia diagnosis, minimizes compliance risks, & aids CDI.

Clinical Decision Support

Checklist
  • 1. Excessive daytime sleepiness >3 months? ICD-10 G47.1, Document sleep diary.
  • 2. Rule out other sleep disorders: narcolepsy, apnea, RLS. Document PSG/MSLT.
  • 3. Evaluate for medical/psychiatric causes, medications. Document comorbidities.
  • 4. Assess impact on daily function, safety. Document Epworth Sleepiness Scale.

Reimbursement and Quality Metrics

Impact Summary
  • Hypersomnia reimbursement hinges on accurate coding (G47.10, G47.11) impacting revenue cycle management.
  • Coding validation and physician documentation crucial for Hypersomnia claims minimizing denials maximizing hospital revenue.
  • Quality metrics for Hypersomnia, like ESS score, influence value-based care reimbursement and patient outcomes reporting.
  • Accurate diagnosis and coding of Hypersomnia (ICD-10 G47.1) impacts hospital quality reporting and potential pay-for-performance incentives.

Streamline Your Medical Coding

Let S10.AI help you select the most accurate ICD-10 codes. Our AI-powered assistant ensures compliance and reduces coding errors.

Quick Tips

Practical Coding Tips
  • Document excessive daytime sleepiness
  • Specify hypersomnia type (primary, secondary)
  • Rule out other sleep disorders
  • Code G47.1 for unspecified hypersomnia
  • Consider 780.54 for other hypersomnia

Documentation Templates

Patient presents with primary complaint of excessive daytime sleepiness (EDS), fulfilling the diagnostic criteria for hypersomnia.  The patient reports persistent sleepiness despite obtaining adequate nocturnal sleep duration, often exceeding seven hours.  Symptoms include difficulty awakening in the morning, prolonged sleep inertia, and daytime sleep attacks or unintended lapses into sleep.  The patient denies any history of cataplexy, sleep paralysis, or hallucinations associated with sleep onset or offset.  Symptoms significantly impact daily functioning, including occupational performance, social interactions, and overall quality of life.  Objective findings include Epworth Sleepiness Scale (ESS) score of [insert score], indicating clinically significant daytime sleepiness.  Differential diagnoses considered include obstructive sleep apnea, restless legs syndrome, circadian rhythm sleep-wake disorders, and other medical conditions potentially contributing to hypersomnia.  Polysomnography and Multiple Sleep Latency Test (MSLT) ordered to objectively assess sleep architecture and confirm the diagnosis, ruling out other sleep disorders.  Initial treatment plan includes behavioral modifications such as regular sleep-wake schedule, optimization of sleep hygiene, and strategic napping.  Pharmacological interventions may be considered following diagnostic testing, with potential options including wake-promoting agents such as modafinil or armodafinil.  Patient education provided regarding the nature of hypersomnia, potential treatment approaches, and importance of follow-up care.  Follow-up scheduled to review test results and adjust treatment plan as needed.  ICD-10 code G47.1 (hypersomnia, not due to a substance or known physiological condition) assigned.
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