ICD-10 Coding for Nocturnal Hypoxemia(G47.36, R09.02)
Complete ICD-10-CM coding and documentation guide for Nocturnal Hypoxemia. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Nocturnal Hypoxemia
G47.30-G47.39Primary Range
Sleep disorders related to breathing
This range includes codes for sleep-related breathing disorders, including those causing hypoxemia.
Symptoms and signs involving the circulatory and respiratory systems
This range includes codes for hypoxemia not linked to sleep disorders or respiratory failure.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| G47.36 | Sleep-related hypoventilation in conditions classified elsewhere | Use when hypoxemia is due to sleep-related hypoventilation linked to another condition. |
|
| R09.02 | Hypoxemia | Use when hypoxemia is documented without meeting criteria for respiratory failure. |
|
Clinical Decision Support
Always review the patient's clinical documentation thoroughly. When in doubt, choose the more specific code and ensure documentation supports it.
Key Information: ICD-10 code for nocturnal hypoxemia
Essential facts and insights about Nocturnal Hypoxemia
Primary ICD-10-CM Codes for nocturnal hypoxemia
Decision Criteria
clinical Criteria
- Presence of sleep study results showing hypoventilation.
documentation Criteria
- Documentation of underlying condition causing hypoventilation.
Applicable To
- Hypoxemia due to sleep-related hypoventilation
Excludes
- Obstructive sleep apnea (G47.33)
Clinical Validation Requirements
- Sleep study showing hypoxemia/hypoventilation
- Underlying condition documented (e.g., obesity)
Code-Specific Risks
- Incorrectly coding without linking to an underlying condition.
Coding Notes
- Ensure the underlying condition is documented and coded first.
R09.02 - Hypoxemia
Use when hypoxemia is documented without meeting criteria for respiratory failure.
Applicable To
- Low blood oxygen levels
Excludes
- Respiratory failure (J96.0-J96.9)
Clinical Validation Requirements
- Oximetry showing SpO2 ≤88% for ≥5 minutes without respiratory failure
Coding Notes
Ensure hypoxemia is documented separately from respiratory failure.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Obesity hypoventilation syndrome
E66.01Differential Codes
Alternative codes to consider when ruling out similar conditions to the primary diagnosis.
Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Nocturnal Hypoxemia to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code G47.36.
Impact
Clinical: Leads to incomplete clinical picture., Regulatory: Non-compliance with coding standards., Financial: Potential claim denials due to insufficient documentation.
Mitigation Strategy
Ensure all relevant conditions are documented in the patient's record.
Impact
Reimbursement: Incorrect coding can lead to claim denials., Compliance: May result in non-compliance with coding guidelines., Data Quality: Affects accuracy of clinical data.
Mitigation Strategy
Use R09.02 for hypoxemia unless acute intervention is documented.
Impact
Inadequate documentation of hypoxemia can lead to audit issues.
Mitigation Strategy
Ensure thorough documentation of oximetry results and related conditions.
Documentation errors, coding pitfalls, and audit risks are interconnected aspects of medical coding and billing. Addressing all three areas helps ensure accurate coding, optimal reimbursement, and regulatory compliance.
Frequently Asked Questions
Common questions about ICD-10 coding for Nocturnal Hypoxemia, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Nocturnal Hypoxemia
Use these documentation templates to ensure complete and accurate documentation for Nocturnal Hypoxemia. These templates include all required elements for proper coding and billing.
Nocturnal Hypoxemia in OSA
Specialty: PulmonologyRequired Elements
- Symptoms
- Oximetry results
- Etiology
- Linkage to underlying condition
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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