In this topic let us look into types of Insomnia, Insomnia ICD 10 guidelines with examples.
Insomnia is a sleep disorder in which the person feels it very difficult to get sleep. This may be for 1 day or few weeks lasting for a short period (acute) or long period (chronic). Mostly insomnia is found in woman over 60 years old.
Types of Insomnia:
Majorly there are 2 different types of Insomnia – Primary and secondary
Primary – This can be due to noise around you, light, weather, due to stress from job or due to personal worries like someone’s death.
Secondary – It is called secondary as it is due to another disease or health condition you have. It may be due to depression, asthma, cancer, arthritis, thyroid problems or so.
Symptoms, Diagnosis, Tests
There can be common symptoms like waking up during night, daytime tiredness, irritability or waking up too early. If these symptoms are troubling you to function during day, Yes it is time to visit a doctor.
Physician will do physical exam and obtain the patient’s history to find out the reason for insomnia. A test called ‘sleep study’ may be done for further investigation.
Insomnia ICD 10 codes and guidelines
Location in ICD-10 CM manual –chapter 6(diseases of nervous system, code range G00-G99) and chapter 5(mental & behavioural disorders, code range F01-F99)
- Remember to check excludes 2 notes when coding for Insomnia. Because the conditions or symptoms which we think are included in Insomnia, may also be coded separately.
For example, along with ICD G47.00 (Unspecified Insomnia) we need to code F51 category codes such as nightmares, sleep walking if documented in the medical record. Alcohol or drug related Insomnia and sleep apnea also can be coded with G47.00 if specified in medical record.
|Insomnia ICD 10 codes||Description|
|G47.01||Insomnia/hyposomnia due to any medical condition|
|F51.01||Insomnia : idiopathic
: Not due to any conditions or substance abuse
|F51.02|| : Short term
: Adjustment disorder
: Stress related
|F51.04|| : Chronic
|F51.05|| : Due to depression or anxiety or any mental disorder
|F51.09||: Not due to any conditions or substance abuse, but specified|
|F10||Insomnia due to Alcohol:
Abuse – F10.182
Dependence – F10.282
Use – F10.982
|F11||Insomnia due to Opioid:
Abuse – F11.182
|F13||Insomnia due to Sedative, anxiolytic or hypnotic:
Abuse – F13.182
Dependence – F13.282
Use – F13.982
|F14||Insomnia due to Cocaine:
Abuse – F14.182
Dependence – F14.282
Use – F14.982
|F15||Insomnia due to Amphetamines, caffeine, other stimulant:
Abuse – F15.182
Dependence – F15.282
Use – F15.982
|F19||Insomnia due to Psychoactive substance or drug:
Abuse – F19.182
Dependence – F19.282
Use – F19.982
|Z73.810 – Z73.819||Childhood insomnia, behavioural|
|A81.83||Familial fatal insomnia|
Few scenarios given below for a clear understanding of coding insomnia.
Insomnia ICD 10 Example 1
Mr. Michael is a 45 year old man who comes to clinic stating “I am unable to sleep from past 3 months”. All his problems started after his twin brother’s death in a car accident. He never had any previous sleep problems. He drinks 4-5 cups of coffee day time and 2 pegs whiskey at night just before sleep. His wife stated that his legs jerk sometimes during sleep. He does not have history of any chronic conditions. All his vitals are normal today. Nothing abnormal found in the physical exam. Diagnosis was mentioned as “adjustment insomnia”
Correct ICD-10 code would be F51.02 (insomnia, adjustment disorder)
Insomnia ICD 10 Example 2
20 year old Jennifer, pursuing her business administration course,is here with a problem of waking up too early in the morning. She has to leave home at 7.00 am to attend the class at 8.00 am. But she wakes up at 3.00 am mostly after seeing a nightmare and unable to fall asleep after that. It gives more stress to her in the day time. She is facing this problem from past one week. Apart from a leg surgery for fracture there is no medical or surgical history and does not use alcohol or drugs. Her BP is 135/85 mm Hg today. She is a healthy, alert and oriented person with no neurological deficits.
Physician made her to undergo a neurological screening test with the help of a behavioural health technician and diagnosed ‘unspecified insomnia’. He prescribed Ambien for a week and instructed to follow up after that.
ICD-10 code for this case is G47.00 (unspecified insomnia) and F51.5 (nightmare).
Note : Nightmare is coded separately as per the excludes 2 notes with G47.00.