Outpatient Facility Coding Alert
Lack of Details Leads to 780.57 for Sleep Apnea
Question: What is the best diagnosis code for complex sleep apnea?
Answer: If the physician is unable to identify the cause of the apnea or if he is still trying to determine the cause, select 780.57 (Unspecified sleep apnea). All the 780.5x codes are “unspecified,” meaning that you should use them only when your physician doesn’t give a specific cause for the condition.
All the 327.2x codes, except 327.20 (Organic sleep apnea, unspecified), are “specified” causes of organic sleep apnea. The physician would have to provide more information about the cause for you to use one of the more specific codes. For example, you can report organic sleep apnea (327.2x) when sleep testing confirms the sleep apnea. The other sleep apnea codes (780.5x) are under the category Symptoms, Signs, and Ill-Defined Conditions, and tie into specific symptoms (such as insomnia, hypersomnia, or sleep related movement disorder).
Texas Subscriber
Outpatient Facility Coding Alert
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