ICD Code G47.00

ICD code G47.00 is used to classify a diagnosis of insomnia that is not specified further. This means that the patient is experiencing difficulty falling asleep or staying asleep, but the exact type or cause of the insomnia has not been detailed in the medical record. This code is often used when the healthcare provider has identified insomnia as a condition but lacks additional information to categorize it more specifically.

1. Difficulty Initiating Sleep: The patient experiences persistent trouble falling asleep despite having the opportunity to do so.

2. Difficulty Maintaining Sleep: The patient frequently wakes up during the night and has trouble returning to sleep.

3. Early Morning Awakening: The patient wakes up too early and is unable to return to sleep.

4. Non-Restorative Sleep: The patient reports feeling unrefreshed or tired despite having a full night's sleep.

5. Daytime Impairment: The patient exhibits symptoms such as fatigue, mood disturbances, or cognitive impairment during the day due to poor sleep quality.

6. Chronicity: The sleep disturbances occur at least three times per week and have persisted for at least three months.

7. Absence of Other Sleep Disorders: The symptoms are not better explained by another sleep disorder, such as sleep apnea or restless legs syndrome.

8. Exclusion of External Factors: The sleep issues are not attributable to environmental factors, such as noise or uncomfortable sleeping conditions.

9. Impact on Daily Functioning: The sleep disturbances cause significant distress or impairment in social, occupational, or other important areas of functioning.

10. Exclusion of Substance Use: The symptoms are not due to the direct physiological effects of a substance, such as a drug of abuse or medication.

For the ICD code G47.00 (Insomnia, unspecified), the relevant CPT codes that may be applicable for treatment and management include:

1. 90832 - Psychotherapy, 30 minutes with patient.

2. 90834 - Psychotherapy, 45 minutes with patient.

3. 90837 - Psychotherapy, 60 minutes with patient.

4. 96127 - Brief emotional/behavioral assessment (e.g., depression inventory, attention-deficit/hyperactivity disorder [ADHD] scale), with scoring and documentation, per standardized instrument.

5. 99201-99205 - New patient office or other outpatient visit, levels 1-5.

6. 99211-99215 - Established patient office or other outpatient visit, levels 1-5.

7. G0396 - Alcohol and/or substance abuse structured assessment and brief intervention, 15 to 30 minutes.

8. G0397 - Alcohol and/or substance abuse structured assessment and brief intervention, greater than 30 minutes.

These CPT codes are commonly used in the context of diagnosing and treating insomnia through various therapeutic and assessment methods. It is important for healthcare providers to select the appropriate CPT code based on the specific services rendered to ensure accurate billing and reimbursement.

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