Neurology & Pain Management Coding Alert

Question: Encounter notes indicate that the patient suffered from “altitude-related sleep apnea.” Should I just report an unspecified sleep apnea code for this condition?

Colorado Subscriber

Answer: There actually is a code for altitude-related sleep apnea: Report G47.32 (High altitude periodic breathing) for the patient’s sleep apnea.

More on the condition: According to Medlink Neurology, “central sleep apnea due to high-altitude periodic breathing affects about a quarter of people who ascend to 2,500 meters [1.55 miles] and almost 100 percent of those who ascend to 4,000 meters [2.48 miles] or higher.”

The condition is characterized by “central apneas, periodic breathing, insomnia, and sleep fragmentation,” reports Medlink.

Periodic breathing definition: For a patient to be diagnosed with high-altitude periodic breathing, the physician should document three apneas of at least 3 seconds each, with less than 20 seconds between intervals.

More on apnea: The G47.3- (Sleep apnea) code set contains nine separate codes for sleep apnea. Here’s a look at the other conditions, and some info on reporting the codes:

• G47.30 (Sleep apnea, unspecified). Also, use this code if the provider lists the diagnosis as “sleep apnea, NOS.”
• G47.31 (Primary central sleep apnea). Also, use this code if the provider lists the diagnosis as “idiopathic central sleep apnea.”
• G47.32
• G47.33 (Obstructive sleep apnea (adult) (pediatric)). Also, use this code if the provider lists the diagnosis as “obstructive sleep apnea hypopnea.
• G47.34 (Idiopathic sleep related nonobstructive alveolar hypoventilation). Also, use this code if the provider lists the diagnosis as “sleep related hypoxia.”
• G47.35 (Congenital central alveolar hypoventilation syndrome)
• G47.36 (Sleep related hypoventilation in conditions classified elsewhere). For this ICD-10 code, be sure to code first the underlying condition.
• G47.37 (Central sleep apnea in conditions classified elsewhere). For this ICD-10 code, be sure to code first the underlying condition.
• G47.39 (Other sleep apnea).

Chris Boucher, MS, CPC, Senior Development Editor, AAPC