Find information on obstructive sleep apnea diagnosis, including relevant healthcare documentation, clinical terminology, and medical coding. Learn about ICD-10 codes for OSA, CPAP treatment, sleep study documentation requirements, AHI interpretation, and polysomnography coding guidelines. This resource provides details on OSA severity levels, medical necessity documentation for sleep apnea testing, and accurate coding for billing and reimbursement. Explore common OSA symptoms, diagnostic criteria, and clinical documentation best practices for healthcare professionals.
Also known as
Obstructive sleep apnea (adult)
Diagnosis of adult obstructive sleep apnea.
Sleep apnea, unspecified
Sleep apnea without specifying obstructive or central.
Central sleep apnea
Sleep apnea caused by central nervous system dysfunction.
Acute respiratory failure
Sudden inability of the lungs to maintain adequate oxygenation or ventilation, which can be a consequence of severe sleep apnea.
Follow this step-by-step guide to choose the correct ICD-10 code.
Is OSA adult or pediatric?
Adult (15+ years)
OSA confirmed by polysomnography?
Pediatric (under 15 years)
OSA confirmed by polysomnography?
When to use each related code
| Description |
|---|
| Obstructive Sleep Apnea |
| Central Sleep Apnea |
| Upper Airway Resistance Syndrome |
ICD-10 code G47.33 requires specific documentation of obstruction location (e.g., nose, oropharynx, tongue). Lack of detail can lead to coding errors and claim denials.
AHI or RDI values must be documented to support severity coding (mild, moderate, severe) for accurate reimbursement and compliant medical coding.
OSA often coexists with hypertension, heart failure, and other conditions. Incomplete documentation of these comorbidities impacts risk adjustment and quality reporting.
Patient presents with complaints consistent with obstructive sleep apnea (OSA). Symptoms include excessive daytime sleepiness, loud snoring reported by bed partner, witnessed apnea episodes, and morning headaches. Patient reports fatigue interfering with daily activities and difficulty concentrating. Review of systems reveals restless sleep, frequent nocturnal awakenings, and gasping or choking during sleep. Past medical history is significant for hypertension and obesity. Physical examination reveals a BMI of 35, enlarged tonsils, and a neck circumference of 43 cm. The STOP-BANG questionnaire score is 6, indicating high risk for OSA. Diagnosis of obstructive sleep apnea is suspected. Differential diagnoses include central sleep apnea, upper airway resistance syndrome, and insomnia. Plan includes referral for polysomnography (sleep study) to confirm the diagnosis and determine apnea-hypopnea index (AHI). Treatment options including continuous positive airway pressure (CPAP) therapy, weight loss, and oral appliance therapy will be discussed following the sleep study. ICD-10 code G47.33 (Obstructive sleep apnea (adult)) is documented. Patient education provided on sleep hygiene, risks of untreated OSA, and importance of adherence to prescribed therapy. Follow-up appointment scheduled in two weeks to review sleep study results and initiate treatment.