Find comprehensive information on sleep apnea diagnosis, including clinical documentation requirements, medical coding guidelines (ICD-10, CPT), and healthcare best practices for obstructive sleep apnea (OSA), central sleep apnea (CSA), and complex sleep apnea. Learn about polysomnography (PSG) interpretation, apnea-hypopnea index (AHI), and other diagnostic criteria for accurate sleep apnea diagnosis and effective treatment. Explore resources for physicians, sleep specialists, and other healthcare professionals involved in sleep medicine.
Also known as
Sleep Apnea
Specifies different types of sleep apnea.
Central Sleep Apnea
Breathing repeatedly stops and starts during sleep due to brain malfunction.
Primary Central Sleep Apnea of Infancy
Breathing repeatedly stops and starts during sleep in infants due to central nervous system issues.
Obstructive Sleep Apnea (Adult) (Pediatric)
Breathing repeatedly stops and starts during sleep due to upper airway obstruction.
Follow this step-by-step guide to choose the correct ICD-10 code.
Is the sleep apnea obstructive?
Yes
Is it adult or pediatric?
No
Is it central sleep apnea?
When to use each related code
| Description |
|---|
| Breathing repeatedly stops and starts during sleep. |
| Daytime sleepiness not explained by other causes. |
| Snoring with witnessed apneas, gasping, or choking. |
Coding G47.30 (sleep apnea NOS) without documenting specific type (obstructive, central, mixed) leads to inaccurate severity and reimbursement.
Insufficient CDI documentation of related conditions (hypertension, obesity, heart failure) impacts risk adjustment and quality reporting for sleep apnea.
Lack of documentation supporting medical necessity for CPAP or patient compliance creates audit risks for claims involving sleep apnea treatment.
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 potential comorbidities including hypertension and obesity. Physical examination reveals a Mallampati score of III. The patient's BMI is 35 kgm2, placing them in the obese range. Based on reported symptoms, physical exam findings, and risk factors, a diagnosis of obstructive sleep apnea is suspected. Differential diagnoses considered include central sleep apnea, upper airway resistance syndrome, and insomnia. A polysomnography (sleep study) is ordered to confirm the diagnosis and assess the apnea-hypopnea index (AHI). Treatment options including continuous positive airway pressure (CPAP) therapy, weight management strategies, and oral appliance therapy will be discussed upon receiving the sleep study results. ICD-10 code G47.33 (Obstructive sleep apnea (adult) confirmed by polysomnography) will be applied pending sleep study confirmation. Patient education provided regarding sleep hygiene practices and the importance of adherence to prescribed treatment. Follow-up appointment scheduled to discuss sleep study results and initiate treatment.