Coding Hypersomnia – An Excessive Daytime Sleep Disorder

by | Published on Sep 21, 2020 | Medical Billing

Coding Hypersomnia - An Excessive Daytime Sleep Disorder
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Health consequences resulting from sleep disorders and excessive tiredness is common among many people. In fact, most people do not realize the importance of sleep. Adequate amount of sleep is vital for both physical mental health of a person. Reports from the Centers of Disease Control and Prevention suggest that about 35 percent of adults in the United States do not get adequate amount of sleep (about 7 hours per day). Insufficient sleep can cause several sleep disorders. Hypersomnia is one such unique sleep disorder in which a person has trouble staying awake during the day time. Also called excessive daytime sleepiness, the condition occurs when a person falls asleep repeatedly during the day time often at inappropriate times, for instance, sometimes in the middle of eating a meal, during a serious conversation, at work, or while driving. Such persons may also have other sleep-related problems, including a lack of energy and trouble thinking clearly. Treatment for this condition may depend on the causes and may generally involve making changes in lifestyle and consuming medications. Sleep medicine specialists treating patients need to maintain accurate documentation regarding the diagnosis and treatment provided. Medical billing and coding for hypersomnia is a complex process as there are several rules related to reporting the procedures accurately. Relying on the services of a reputable and experienced medical billing company can help in accurate and timely claim submission for appropriate reimbursement.

According to the National Sleep Foundation, up to 40 percent of people have some symptoms of hypersomnia from time to time. The American Sleep Association suggests that the condition affects men more than women. Regular smokers or drinkers are at considerable risk of developing hypersomnia. Also, medical issues such as sleep apnea, depression disorders, low thyroid function and heart and kidney conditions can also contribute to developing this condition.

Types of Hypersomnia and Causes

Hypersomnia can be either primary or secondary. The causes of this condition may depend on the type of disorder a person suffers from. Primary hypersomnia is generally caused by problems in the brain systems that control sleep and waking functions. Conditions that cause fatigue or inadequate sleep lead to secondary hypersomnia.  Sleep apnea, kidney failure, Parkinson’s disease and chronic fatigue syndrome are other medical conditions that could lead to this condition. These conditions can lead to poor sleep at night making the person feel tired during the day. In some cases, use of certain medications (such as tranquilizers or antihistamines), frequent drug and alcohol use and obesity may also trigger excessive sleepiness during the day. Other possible causes include low thyroid function, head injury or a neurological disease (such as multiple sclerosis or Parkinson’s disease) and genetics (having a relative with hypersomnia).

Symptoms of Hypersomnia

Constant tiredness is one of the main symptoms associated with the condition. People may take naps throughout the day without ever relieving drowsiness. They may also have difficulty waking up from long periods of sleep. Other related symptoms include – slow thinking or speech, irritability, restlessness, low energy, loss of appetite, anxiety and difficulty remembering things.

How to Effectively Diagnose and Treat Hypersomnia

Persons who constantly feel drowsy or tired during the day time need to consult a sleep medicine specialist. As an initial step of diagnosis, the sleep medicine specialist will perform a detailed review of the patient’s symptoms and previous medical history. The physician will enquire about the patient’s sleeping habits, amount of sleep at night, whether he/she wakes up at night (at regular intervals) or falls asleep during the day. Physicians will also enquire whether the patient has any emotional problems or is consuming any drugs that may interfere with the sleep.

Sleep medicine specialists may perform several tests like – maintaining a sleep diary (to record sleep and awake times), Epworth Sleepiness Scale, Multiple Sleep Latency test (measures the types of sleep) and Polysomnogram (to monitor brain activity, eye movements, heart rate, oxygen levels, and breathing functions). In addition, a physical examination may be conducted to test for alertness.

Treatments for this condition can vary, depending on the causes of the hypersomnia. Medications comprising stimulants (like amphetamine, methylphenidate, and modafinil) may be prescribed that help patients feel more awake. Other medications include – clonidine, levodopa, bromocriptine, antidepressants, and monoamine oxidase inhibitors. Physicians may also offer a treatment known as continuous positive airway pressure (CPAP). With CPAP, patients need to wear a mask over their nose while sleeping. A machine that delivers a continuous flow of air into the nostrils is hooked up to the mask. The pressure from the air flowing into the nostrils helps keep the airways open. Apart from this, lifestyle changes are an important part of the treatment process. Physicians may ask patients to maintain a clear and definite sleeping schedule. Avoiding certain lifestyle habits like consuming alcohol and using drugs can reduce the severity of symptoms. In addition, maintaining a high-nutrition diet may help keep up the energy levels naturally.

Sleep medicine specialists or other physicians who diagnose and treat different types of hypersomnia must carefully document the diagnostic tests and other procedures using the correct medical codes. Medical billing and coding services provided by established billing companies can help physicians use the correct codes for their medical billing process. ICD-10 codes for diagnosing hypersomnia include –

  • G47.1 Hypersomnia
  • G47.10 Hypersomnia, unspecified
  • G47.11 Idiopathic hypersomnia with long sleep time
  • G47.12 Idiopathic hypersomnia without long sleep time
  • G47.13 Recurrent hypersomnia
  • G47.14 Hypersomnia, due to medical condition
  • G47.19 Other hypersomnia

Hypersomnia is not a lethal condition, but it could affect a person’s quality of life. Appropriate lifestyle changes can help improve the symptoms. Changes in lifestyle or behavior (like avoiding night work and social activities that delay bed time) and diet may offer some relief. Patients should also limit or avoid the intake of alcohol and caffeine. Medications can help improve the symptoms to some extent. However, some people may never get complete relief.

As allergy and sleep medicine medical billing and coding is challenging and time-consuming, physicians can consider hiring medical coding services. This would ensure accurate reporting of diagnostic details and help avoid delayed / denied claims.

Natalie Tornese

Holding a CPC certification from the American Academy of Professional Coders (AAPC), Natalie is a seasoned professional actively managing medical billing, medical coding, verification, and authorization services at OSI.

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