CPAP ICD-10-CM Codes
Read this short guide and learn about CPAP ICD codes you can use.
Fact Checked by Ericka Pingol.
What CPAP ICD codes can I use?
If you’re looking for CPAP ICD codes, you’ll have to look for specific codes that are for problems that CPAP machines address. CPAP machines are used to treat sleep apnea, and there are numerous ICD-10 codes for that condition and its different types.
Here are some of the sleep apnea-related ICD codes that you can use:
- G47.30 - Sleep apnea, unspecified
This ICD-10 code is meant to be used on a patient confirmed to have sleep apnea, a sleeping disorder characterized by the person who stops breathing while sleeping at intervals, so the brain activates and wakes the person up to resume breathing. CPAP machines are used to treat this disorder.
The unspecified means that the type of sleep apnea is not known or identified at the moment. There are different types of sleep apnea, like central, obstructive, and mixed/complex sleep apnea. It’s best to use a more specific ICD-10 code once the specific type is identified.
- G47.31 - Primary central sleep apnea
This ICD-10 code is meant to be used on a patient confirmed to have Primary Central Sleep Apnea, which is characterized by a brain problem that disrupts its function to send signals to breathing-related muscles.
- G47.32 - High altitude periodic breathing
This ICD-10 code is meant to be used on a patient confirmed to have high altitude periodic breathing, which means that the patient has unstable breathing caused by reduced oxygen content in their blood due to being in a place with high altitude. This can result in Central Sleep Apnea.
- G47.33 - Obstructive sleep apnea (adult) (pediatric)
This ICD-10 code is meant to be used on a patient confirmed to have Obstructive Sleep Apnea. This type of sleep apnea is characterized by the relaxation of a person’s head and neck muscles. The relaxation of these muscles causes nearby tissues to press on the patient’s windpipe, obstructing the airways.
- G47.37 - Central sleep apnea in conditions classified elsewhere
This ICD-10 code is meant to be used on a patient confirmed to have Central Sleep Apnea. It’s best to check first if the type of Central Sleep Apnea your patient is dealing with doesn’t have a specific ICD-10 code. If it is caused by certain conditions that are not covered by certain ICD-10 codes, you can use this.
- G47.00 - Insomnia, unspecified
This ICD-10 code is meant to be used on a patient with insomnia. The unspecified is for the specific type of insomnia the patient is dealing with. Insomnia is a symptom of Central Sleep Apnea, and Central Sleep Apnea can be addressed using a CPAP machine, which, by extension, may address insomnia.
Are these CPAP ICD codes billable?
Yes. These CPAP-related ICD-10 codes are valid and billable.
Clinical information about sleep apnea:
As previously mentioned, sleep apnea is a sleep disorder that intermittently interrupts a person's breathing while asleep. When this occurs, the brain sends signals to wake the person up, leading to a resumption of breathing. This disruption in breathing can be caused by an obstruction in the airways or a dysfunction in the brain's respiratory control. Consequently, individuals with sleep apnea experience insufficient restful sleep, which can harm their overall well-being, particularly on the heart.
There are three types of sleep apnea: Central Sleep Apnea, Obstructive Sleep Apnea, and Mixed/Complex Sleep Apnea. We have already provided a brief overview of Central Sleep Apnea and Obstructive Sleep Apnea.
Those who have sleep apnea will exhibit/experience the following symptoms:
- Insomnia
- Hypersomnia (or daytime sleepiness)
- They will snore a lot, in some cases loudly
- They will have unusual breathing patterns while sleeping
- They will likely wake up a lot at night
- They will sweat a lot at night and wake up
- They will feel tired when they wake up
- They will be susceptible to mood changes
- They’re prone to getting headaches due to a lack of restful sleep
- They will feel restless and anxious
Synonyms include:
- Breathing-related sleep disorder
- Hypersomnia with sleep apnea
- Insomnia with sleep apnea
- Central sleep apnea syndrome
- Central sleep apnea without Cheyne-Stokes respiration
- Dependence on biphasic positive airway pressure ventilation
- Dependence on ventilator
- Primary central sleep apnea
- Central sleep apnea caused by high altitude
- High altitude periodic breathing
- Obstructive sleep apnea of adult
- Obstructive sleep apnea of child
Commonly asked questions
No. CPAP, or CPAP machine, is a device used to help address sleep apnea. It is not a condition, so it doesn’t have an ICD-10 code. That’s why it’s best to use ICD-10 codes related to sleep apnea.
Healthcare professionals/providers will conduct either a Home Sleep Apnea Test or a Polysomnogram (an overnight sleep study).
As you can tell, CPAP machines are one way to address sleep apnea. Other ways to treat/manage this sleep disorder include using nasal sprays, adhesive strips, losing weight, nerve stimulators, and sleep aid items. Surgery is an option, but only for severe cases. Examples of surgery for sleep apnea include somnoplasty, nasal surgery, and jaw surgery.
