tci ED Coding & Reimbursement Alert - 2008 Issue 10

Reader Questions: ICD-9 Code Choice Depends on Apnea's Cause

Question: The ED physician performs a level-two E/M on a patient with sleep issues. The medical record indicates that the patient had obstructive sleep apnea caused by excess weight. Should I use ICD-9 code 780.51 to represent this condition? Minnesota Subscriber Answer: Code 780.51 (Insomnia with sleep apnea, unspecified) is not specific enough for your scenario. Use 780.51 when the physician cannot (or has not yet) determined the cause of the condition. Because the physician noted that excess weight caused the apnea, you should instead choose 327.23 (Obstructive sleep apnea [adult] [pediatric]) as a diagnosis...

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