2025 ICD-10-CM code G47.19
(Valid) Effective Date: N/A Diseases of the nervous system - Sleep disorders 6 Feed
Other hypersomnia. This code is used for hypersomnia that is not described by other codes, such as hypersomnia due to medical conditions or other specified types.
Medical necessity for the diagnosis and management of other hypersomnia must be supported by documentation of the impact of the excessive daytime sleepiness on the patient's daily life and functioning. The rationale for the chosen treatment approach should be clearly documented, connecting the interventions to the patient's specific symptoms and needs.
Clinicians diagnose other hypersomnia based on patient history, including sleep patterns and daytime sleepiness, along with a physical exam.Additional tests, such as sleep studies (polysomnography) or blood tests, may be conducted to rule out other medical conditions. Treatment often focuses on managing symptoms and improving sleep hygiene.Medications, such as stimulants or antidepressants, may be prescribed, while behavioral therapies like cognitive behavioral therapy for insomnia (CBT-I) might also be helpful. Clinicians also advise patients on lifestyle modifications, including diet and limiting alcohol and caffeine intake to promote better sleep.
In simple words: This code is used when someone has excessive daytime sleepiness, even after a good night's sleep, and it's not caused by another known condition like sleep apnea or a medical problem.
Other hypersomnia refers to a sleep disorder characterized by excessive daytime sleepiness, even after getting adequate sleep at night.Individuals with this condition may fall asleep unintentionally during the day, struggle to stay awake, and experience difficulty waking up. This code excludes hypersomnia related to alcohol or drug use, mental disorders, or known physiological conditions like sleep apnea.
Example 1: A patient reports excessive daytime sleepiness despite getting 8 hours of sleep nightly. After ruling out other sleep disorders and medical conditions, the physician diagnoses other hypersomnia., A patient with a history of daytime sleepiness undergoes a sleep study, which does not reveal any underlying sleep apnea or other specific sleep disorders. The provider documents the diagnosis as other hypersomnia., A patient experiences prolonged periods of sleep and finds it difficult to wake up in the morning. A thorough medical evaluation does not find any underlying cause for their excessive sleepiness. The physician uses G47.19 to code the diagnosis of other hypersomnia, as it is not attributed to any specific medical condition, substance use, or other classified sleep disorders.
Documentation should include details of the patient's sleep history, symptoms like daytime sleepiness, fatigue, and difficulty waking up. Results of any sleep studies, including polysomnography if conducted, are crucial. Also include any other medical evaluations or tests done to rule out other conditions. The treatment plan, whether medication, lifestyle changes, or behavioral therapy, should also be documented.
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