2025 ICD-10-CM code F51.8
(Active) Effective Date: N/A Revision Date: N/A Deletion Date: N/A Mental, Behavioral and Neurodevelopmental disorders - Other sleep disorders not due to a substance or known physiological condition Chapter V: Mental and behavioural disorders Feed
This code classifies sleep disorders without a known physiological or substance-related cause.
Modifiers are not applicable to ICD-10 codes.
Medical necessity for treatment of F51.8 is established when the sleep disorder significantly impacts the patient's daily functioning, relationships, and overall well-being.The provider must demonstrate that the treatment chosen is appropriate and necessary for improving the patient's condition.
The clinical responsibility for diagnosing and treating F51.8 lies with healthcare professionals, such as psychiatrists, psychologists, sleep specialists, or primary care physicians, depending on the complexity and associated symptoms.
- Chapter V: Mental and behavioural disorders
- F51-F59: Behavioral syndromes associated with physiological disturbances and physical factors
In simple words: This code covers sleep problems that aren't caused by a physical illness or drug use.Doctors diagnose this based on your symptoms and may use tests like sleep studies to help. Treatment might include medicine, therapy, or lifestyle changes.
F51.8, Other sleep disorders not due to a substance or known physiological condition, encompasses sleep disturbances stemming from psychological or emotional factors, excluding those linked to identifiable physical conditions or substance use.Diagnosis involves a comprehensive patient history, symptom evaluation, behavioral assessment, and possibly polysomnography, EEG, or genetic testing. Treatment strategies may incorporate anxiolytics, sedatives, melatonin, cognitive behavioral therapy (CBT) targeting sleep hygiene, relaxation techniques, and exercise.
Example 1: A patient presents with chronic insomnia, anxiety, and difficulty concentrating.After ruling out physical causes, the provider diagnoses F51.8 based on the patient's history, psychological evaluation, and sleep diary., A child experiences recurrent nightmares and sleep terrors, impacting their daytime functioning.Following a thorough assessment, a diagnosis of F51.8 is made, and the provider recommends CBT and parental support., An adult reports excessive daytime sleepiness despite adequate sleep at night, experiencing significant impairment in daily activities.Medical tests show no underlying physical cause, leading to a diagnosis of F51.8 and potential referral to a sleep specialist.
Detailed patient history, including sleep patterns, symptoms, and psychosocial factors.Results of any relevant physical examinations, sleep studies (polysomnography, EEG), or psychological evaluations.Documentation of the treatment plan, including therapies and medications used.
** Accurate coding requires careful consideration of the patient's symptoms, thorough evaluation to rule out other causes, and application of official coding guidelines to differentiate F51.8 from other sleep disorders.
- 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 rendered, coded using CPT or HCPCS codes, and their associated RVUs.
- Global Days : Not applicable to this diagnostic code.
- Payment Status: Active
- Modifier TC rule: Not applicable to this diagnostic code.
- Fee Schedule : Not applicable to this diagnostic code.
- Specialties:Psychiatry, Psychology, Sleep Medicine, Family Medicine, Internal Medicine
- Place of Service:Office, Hospital, Outpatient clinic, Home