2025 ICD-10-CM code F51.5

Nightmare disorder, also known as dream anxiety disorder, involves frequent, recurring, frightening dreams that significantly disrupt sleep and cause distress.

Code also any relevant associated mental disorder, medical condition, or other sleep disorder immediately after the code for nightmare disorder to indicate the association.

Medical necessity is established when frequent and severe nightmares significantly impair the patient's sleep, causing daytime dysfunction and significant distress.The diagnosis should be supported by clinical evaluation and detailed documentation.

Diagnosis is based on patient history, signs and symptoms, a detailed inquiry into personal and social behavior, and physical examination. Polysomnography may be used. Treatment may include addressing underlying disorders, counseling, and stress reduction techniques. Medications are rarely prescribed, but anxiolytics and imagery rehearsal therapy might be used for associated PTSD.

IMPORTANT ICD-9-CM code 307.47 (Other dysfunctions of sleep stages or arousal from sleep) is a possible crosswalk, but direct equivalence is not guaranteed due to differences in coding systems.

In simple words: Nightmare disorder means having frequent, scary dreams that wake you up and leave you feeling upset. These nightmares are intense, disturbing, and you remember them clearly.It's different from just having occasional bad dreams.This disorder can affect your daily life, making it hard to sleep and function normally.

Nightmare disorder, also known as dream anxiety disorder, is characterized by repeated occurrences of extended, extremely dysphoric, and well-remembered dreams. These dreams typically involve threats to survival, security, or physical integrity and usually occur during the second half of the major sleep episode. Upon awakening, the individual quickly becomes oriented and alert.The sleep disturbance causes clinically significant distress or impairment in social, occupational, or other important areas of functioning.The nightmare symptoms are not attributable to substance use or a known physiological condition, and coexisting mental or medical disorders do not adequately explain the predominant complaint of dysphoric dreams.The disorder can be specified as acute (lasting one month or less), subacute (lasting more than one month but less than six months), or persistent (lasting six months or more), and severity can be rated by frequency (mild, moderate, or severe).

Example 1: A 7-year-old child experiences frequent nightmares involving monsters and being chased, waking up screaming and crying several times a week. This significantly disrupts their sleep and causes daytime fatigue and anxiety., An adult with a history of PTSD experiences vivid, recurrent nightmares related to their traumatic experience, leading to insomnia, anxiety, and difficulty concentrating at work., A young adult experiences nightly nightmares, often involving themes of failure or social rejection.These nightmares contribute to depression and social isolation, impacting their academic performance and relationships.

Detailed patient history including frequency, duration, content of nightmares, associated symptoms (e.g., sweating, rapid heartbeat, confusion), impact on daily life, and any relevant medical or psychiatric history. Sleep diary documenting sleep patterns and nightmare episodes.Results of polysomnography if performed. Documentation of treatment plan and response.

** While nightmares are common, this code is specifically for the diagnosis of Nightmare Disorder, which requires a certain frequency and severity of nightmares along with significant impact on daily functioning.It's essential to differentiate occasional nightmares from this clinical condition. The use of this code should be based on a thorough clinical evaluation.

  • Payment Status: Active
  • Specialties:Psychiatry, Sleep Medicine, Pediatrics
  • Place of Service:Office, Hospital Inpatient, Hospital Outpatient
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