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Coding questions

Discussion in 'Sleep Medicine' started by danielmd06, 09.15.11.

  1. danielmd06

    danielmd06 Neurosomnologist

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    Hey guys. Is there a website detailing ICD-9 coding specifics? I've already seen their "free online" site and it doesn't include information on diagnoses.

    1) I am curious how you bill UARS/OSA by RDI criteria (I've been coding as Sleep Apnea, Unspecified (780.57).

    2) Also, if someone snores on a PSG, but has no evidence of SDB, do you simply code for Snoring (786.09) despite the ICSD-2 guidelines stating that one cannot be hypersomnolent to be diagnosed with primary snoring.

    3) Are you guys coding for hypersomnia, unspecified (780.54) with persistent hypersomnolence depsite adequately (or inadequately) treated OSA or do you use the hypersomnolence with OSA code (can't remember the number)?

    Sorry! I'm in practice by myself and didn't have anyone directly available to ask.

    Regards,

    Dan
  2. lidocayne

    lidocayne Chief Resident

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    Dan-

    1. You could bill UARS (with normal AHI and elevated RDI) as 327.8
    2. Primary snoring is, as you said, 786.09
    3. I use 780.53 (Hypersomnia with Sleep Apnea, Unspecified)

    Good luck!
  3. michaelrack

    michaelrack All In at the wrong time SDN Advisor

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    you can- ICSD-2 has little to do with what you put on a charge sheet. 786.09 is "snoring" not "primary snoring".

    not all insurance companies will reimburse for this code.
  4. danielmd06

    danielmd06 Neurosomnologist

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    Thanks Mike and lidocayne.
  5. danielmd06

    danielmd06 Neurosomnologist

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    Hello again everyone.

    For central sleep apnea in a patient on narcotics (without heart failure), do you guys use 327.27 (for complex sleep apnea)? If so, what is the secondary code (for the etiology)? For instance, I see patients with Cheyne-Stokes breathing and code 327.27, then 786.04.

    I guess the same question holds for obesity hypoventilation syndrome. How have you guys coded for that? 327.24 is "sleep related hypoventilation."

    Thanks to anyone who replies.
  6. michaelrack

    michaelrack All In at the wrong time SDN Advisor

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    I am probably doing it wrong, but I just use the code 327.21 for all forms of central sleep apnea (complex sleep apnea would be 327.23 and 327.21).

    Since most pts with Obes hypovent have osa, I just use the osa code (327.23). You could add 799.02 for hypoxemia if you like.



    I guess if you do see a case of classic Cheyne Stokes, you should use that specific code. It's been a long time since I have seen a pure case of this.
    Last edited: 09.25.12

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