As a medical coding auditor with 12+ years of experience, I’ve resolved $ 500 K+ in denied claims due to incorrect insomnia coding. Let’s simplify ICD-10 codes for insomnia, sleep disorders, and comorbidities like anxiety, with real-world examples to ensure clean claims.
The main ICD-10 code for insomnia is G47.00 (unspecified insomnia disorder). However, specificity is key to avoid denials:
Example: A patient diagnosed with insomnia and sleep apnea = G47.00 + G47.33.
Case Study: A Texas clinic reduced denials by 40% by replacing G47.00 with G47.01 for chronic cases.
Critical Rule: Always code the underlying condition first (e.g., F32.9 before G47.00 for depression-induced insomnia).
Example: A patient with insomnia and apnea = G47.00 + G47.33.
Before the implementation of ICD-10 in October 2015, insomnia became coded under ICD-9. The number one code used turned into 780.52 (Insomnia, unspecified).
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Use G47.01 (chronic) or G47.09 (other specified) based on documentation.
DSM-5’s “Insomnia Disorder” maps to G47.00-G47.09 (not F51.01).
Yes code both (e.g., G47.00 + G47.33) if both are treated.*
G47.09 + T code (e.g., T45.1X5A for steroid-induced insomnia).*
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