Otolaryngology Coding Alert

Hint: Knowing the type points you to the diagnosis.

A study presented at the 2014 American Thoracic Society International Conference in May found that people with sleep apnea might have a higher risk of hearing loss – which means your otolaryngologist might start treating more patients who’ve been diagnosed with sleep apnea. Be sure you understand the condition so you can correctly code the associated diagnosis.  

Determine Obstructive Vs. Central Type

Sleep apnea is a serious disorder characterized by a person’s breathing being interrupted during sleep. People with untreated sleep apnea stop breathing repeatedly during their sleep, which can deprive the brain -- and the rest of the body -- of getting enough oxygen.

There are two types of sleep apnea:

• Obstructive sleep apnea (OSA): The more common of the two forms of apnea, it is caused by a blockage of the airway, usually when the soft tissue in the back of the throat collapses during sleep.
• Central sleep apnea: Unlike OSA, the patient’s airway is not blocked, but the brain fails to signal the muscles to breathe due to instability in the respiratory control center.

Choose the Correct Diagnosis

Although the otolaryngologist might not be treating the patient’s sleep apnea, you can include it as an underlying condition that could potentially affect treatment. ICD-9 includes several diagnoses for sleep apnea, based on how much information the physician documents about the patient’s case. Your choices are:

• 327.23 – Obstructive sleep apnea (adult) (pediatric)
• 780.51 – Insomnia with sleep apnea, unspecified
• 780.53 – Hypersomnia with sleep apnea, unspecified
• 780.57 – Unspecified sleep apnea.

ICD-10 note: After October 1, 2015, diagnosis 327.23 will switch to G47.33 (Obstructive sleep apnea [adult] [pediatric]). Diagnoses 780.51, 780.53, and 780.57 will be reported as G47.30 (Sleep apnea, unspecified).