2025 ICD-10-CM code G47.0
(Active) Effective Date: N/A Diseases of the nervous system - G47 6 Feed
Insomnia.
Medical necessity for insomnia treatment depends on how much it impacts a person's daily life and health.Treatments are considered medically necessary when insomnia significantly affects daytime functioning, mood, cognitive abilities, or overall well-being.
Clinicians diagnose insomnia based on medical and sleep history, signs and symptoms, and physical examination. A sleep study (polysomnogram) might be ordered for more details if a sleep disorder is present. Treatment depends on the underlying cause and severity of insomnia, with options that might include modifying sleep habits, cognitive behavioral therapy, and medications to improve sleep.
In simple words: Insomnia is a common sleep problem where you have trouble falling asleep, staying asleep, or both.This can make you feel tired and grumpy during the day, and it can make it hard to concentrate.It can be short-term, lasting a few days or weeks, or long-term, lasting for months.Doctors can help figure out why you're having trouble sleeping and suggest ways to get better sleep.
Insomnia is a sleep disorder characterized by difficulty falling asleep, staying asleep, or both. This can lead to insufficient or poor-quality sleep, leaving individuals feeling unrefreshed upon waking.It can be acute (short-term) or chronic (long-term). Acute insomnia is typically caused by stress, life events, or disruptions to sleep patterns and can last for days or weeks. Chronic insomnia persists for three months or longer and may be linked to underlying medical or psychological conditions, medications, or other sleep disorders.Insomnia can negatively impact daytime functioning, causing sleepiness, fatigue, irritability, difficulty concentrating, and memory problems.Diagnosis involves evaluating sleep history, symptoms, and physical examination, and may include a sleep study (polysomnography) to assess sleep stages and identify underlying sleep disorders. Treatment varies depending on the cause and severity, ranging from lifestyle changes and improved sleep hygiene to cognitive behavioral therapy (CBT) and medication.
Example 1: A patient presents with difficulty falling asleep for the past two weeks due to work-related stress.This is diagnosed as acute insomnia., A patient reports having trouble staying asleep and waking up too early for the past six months.They experience daytime fatigue and difficulty concentrating.Further evaluation reveals an underlying anxiety disorder contributing to chronic insomnia., An older adult patient complains of frequent awakenings during the night and difficulty returning to sleep.A sleep study reveals periodic limb movement disorder (PLMD), which is causing secondary insomnia.
Documentation for insomnia should include: detailed sleep history (sleep patterns, duration, quality, daytime sleepiness); presence and duration of insomnia symptoms; impact of insomnia on daytime functioning; any associated medical or psychological conditions; medications; substance use (caffeine, alcohol, nicotine); sleep hygiene practices; results of any sleep studies (e.g., polysomnography); treatment plan.
- Payment Status: Active
- Specialties:Sleep medicine, neurology, psychiatry, primary care.
- Place of Service:Office, Inpatient Hospital, Outpatient Hospital, Telehealth Provided in Patient’s Home, Telehealth Provided Other than in Patient’s Home.