Sleep medicine specialists diagnose and treat sleep disorders including obstructive sleep apnea, insomnia, narcolepsy, and REM sleep behavior disorder. Accurate ICD-10 coding and proper polysomnography billing are essential for Medicare and commercial payer reimbursement. This page lists the top codes used in sleep medicine practices.
G47.33 (obstructive sleep apnea) is distinct from G47.31 (primary central sleep apnea) and G47.30 (unspecified sleep apnea) — specify the type based on the sleep study interpretation.
Polysomnography (95810) requires a minimum of 4 additional channels beyond airflow, oxygen saturation, and heart rate to be billed correctly.
CPAP titration study (95811) must be a full attended polysomnography with CPAP applied — home sleep apnea tests (95800) cannot be used for titration.
Document the AHI, RDI, and nadir oxygen saturation in every sleep study interpretation report to support G47.33 diagnosis and CPAP/BiPAP equipment orders.
G47.33 is Obstructive Sleep Apnea (OSA) — the most common sleep apnea code. G47.31 is Central Sleep Apnea. G47.30 is unspecified and should be avoided when the type has been determined by sleep study. The OSA code supports CPAP/BiPAP equipment orders and prior authorization.
What is the difference between 95810 and 95811?
95810 is a diagnostic polysomnography (sleep staging with 4+ parameters) without PAP therapy. 95811 is a CPAP titration polysomnography, performed when OSA has already been diagnosed and CPAP pressure needs to be set. Both require a technologist in attendance.
Can a home sleep test diagnose OSA?
Yes. 95800 (home sleep apnea test, 3+ channels) can diagnose uncomplicated OSA in adults without significant comorbidities per CMS coverage. However, it cannot be used for CPAP titration — a full in-lab polysomnography (95811) is required for titration.
What is the ICD-10 code for insomnia?
G47.00 is Insomnia, unspecified. F51.01 is Primary insomnia (when no underlying medical or psychiatric cause is identified). G47.01 is Insomnia due to a medical condition. Code the most specific type supported by the documentation.
How does OmniMD support sleep medicine practices?
OmniMD’s Sleep Medicine EHR integrates polysomnography report uploads, AHI-based diagnosis coding suggestions, CPAP compliance tracking (from ResMed/Philips data feeds), and DME order management with medical necessity documentation.
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