Neurology & Pain Management Coding Alert

Question: The physician diagnoses a three-year-old child with obstructive sleep apnea with adenotonsillar hyperplasia. Should we code 327.23 or 780.57 for the sleep apnea?

Answer: Because the neurologist specified obstructive sleep apnea, report 327.23 (Obstructive sleep apnea [adult] [pediatric]). Diagnosis 780.57 (Unspecified sleep apnea) represents cases without obstruction or without enough details in the documentation to report 327.23. Notice that the ICD-9 code 327.73 includes adults and children in the descriptor. The parenthesis are used to indicate supplementary words that may be present or absent without affecting the diagnosis code, so 327.23 is the correct choice for obstructive sleep apnea at any age.