2025 ICD-10-CM code F51.19
(Active) Effective Date: N/A Revision Date: N/A Deletion Date: N/A Mental and behavioral disorders - Other hypersomnia Chapter V: Mental and behavioural disorders Feed
Other hypersomnia not due to a substance or known physiological condition.
ICD-10 codes do not utilize modifiers.Modifiers are applied to procedure codes (CPT, HCPCS).
Medical necessity for treatment is established based on the presence of significant daytime sleepiness negatively impacting the patient's daily functioning and well-being.The diagnosis of F51.19 must be supported by clinical findings excluding other causes and indicating the presence of a psychogenic sleep disorder.
The clinical responsibility for this diagnosis lies with a psychiatrist or other qualified mental health professional.They conduct the evaluation, diagnose the condition, and develop a treatment plan.
- Chapter V: Mental and behavioural disorders
- F51-F59: Behavioral syndromes associated with physiological disturbances and physical factors
In simple words: This code describes excessive sleepiness during the day even after getting enough sleep at night, without a clear physical or drug-related cause. Doctors diagnose this by reviewing your medical history, examining you, and possibly using sleep tests. Treatment might involve medications, counseling, and improving sleep habits.
This code classifies hypersomnia (excessive daytime sleepiness despite adequate nighttime sleep) that is not caused by a substance or identifiable physiological condition.It's a psychogenic sleep disorder, meaning it originates from mental or emotional factors. Diagnosis involves a thorough patient history, physical exam, and potentially polysomnography, multiple sleep latency tests, and sleep diaries.Treatment may include stimulant medications, sleep hygiene counseling, and addressing underlying psychological issues.
Example 1: A 35-year-old patient presents with excessive daytime sleepiness despite reporting 8 hours of sleep nightly.They have no history of substance abuse and a normal physical exam. Polysomnography is unremarkable, but a multiple sleep latency test shows increased sleep latency. F51.19 is used to code this case of psychogenic hypersomnia., A 22-year-old college student reports struggling with overwhelming fatigue and difficulty concentrating throughout the day, impacting their academic performance. They have ruled out medical and substance-related causes for their sleepiness.This case could also be coded with F51.19 after a full assessment., A 40-year-old patient experiences significant daytime sleepiness following a period of intense stress at work. Physical and laboratory findings are normal and ruled out underlying medical conditions. Psychological evaluation reveals signs of depression, with the hypersomnia being a symptom. F51.19 can be a secondary diagnosis in conjunction with a depression diagnosis.
Detailed patient history including sleep patterns, daytime sleepiness, and any potential contributing psychological factors. Results of any sleep studies performed (polysomnography, multiple sleep latency test).Physical examination findings excluding underlying medical conditions.Mental health assessment to rule out other disorders and identify potential contributing factors. Documentation of treatment plan including any medications, counseling, or lifestyle modifications.
** Accurate coding requires a comprehensive evaluation to differentiate F51.19 from other types of hypersomnia.Consider using additional codes to describe any comorbid conditions affecting the patient’s sleep.
- Revenue Code: Revenue codes will vary depending on the specific services provided (e.g., evaluation and management, psychotherapy).
- RVU: RVUs are not directly associated with ICD-10 codes.Reimbursement is determined by the procedures and services billed with CPT or HCPCS codes, and the specific payer's fee schedule.
- Global Days : Not applicable to ICD-10 codes.
- Payment Status: Active
- Modifier TC rule: Not applicable to ICD-10 codes.
- Fee Schedule : Not applicable to ICD-10 codes.Fee schedules apply to procedure codes.
- Specialties:Psychiatry, Sleep Medicine
- Place of Service:Office, Hospital Inpatient, Hospital Outpatient, Other