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Sleep Apnea v.s. Obstructive Sleep Apnea - ICD-10 Code for Sleep apnea

  1. #1
    Default Sleep Apnea v.s. Obstructive Sleep Apnea - ICD-10 Code for Sleep apnea
    Medical Coding Books
    I am hoping there is someone out there that can clarify a coding issue I have. I do coding for a facility in which we provide Sleep Study services. I have recently began to question a code that I am using and hope I can find some clarity. If I get a order that simply states Sleep Apnea I will use the 780.57 diagnosis however, there are some patient's that come back a month or two later for there follow up study...and the reports says patient is being treated for OSA (obstructive sleep apnea) in which I use the V67.59 (for follow-up) and then the 327.23 for the OSA. My question comes up in a coding clinic I read 4Q2005 which states the codes for the OSA is for organic disorders....I am confused on this
    Any insight would be very much appreciated.

  2. #2
    International Member
    Hey, I've following details regarding that, Check out, Hope it helps....

    Obstructive sleep apnea (OSA) is a common sleep apnea caused by obstruction of the airway. It is characterized by pauses in breathing during sleep.

    Clinically significant levels of sleep apnea are defined as five or more episodes per hour of any type of apnea (from the polysomnogram). There are three distinct forms of sleep apnea: central, obstructive, and complex (i.e., a combination of central and obstructive) constituting 0.4%, 84% and 15% of cases respectively.[2] Breathing is interrupted by the lack of respiratory effort in central sleep apnea; in obstructive sleep apnea, breathing is interrupted by a physical block to airflow despite respiratory effort. In complex (or "mixed") sleep apnea, there is a transition from central to obstructive features during the events themselves.

    Many people experience episodes of obstructive sleep apnea for only a short period of time. This can be the result of an upper respiratory infection that causes nasal congestion, along with swelling of the throat, or tonsillitis that temporarily produces very enlarged tonsils. The Epstein-Barr virus, for example, is known to be able to dramatically increase the size of lymphoid tissue during acute infection, and obstructive sleep apnea is fairly common in acute cases of severe infectious mononucleosis. Temporary spells of obstructive sleep apnea syndrome may also occur in individuals who are under the influence of a drug (such as alcohol) that may relax their body tone excessively and interfere with normal arousal from sleep mechanisms

  3. #3
    I have read the same information and even though it is good information it still does not help me distinguish between the 2 different codes. Thanks for the input though

  4. Default
    have you found an answer yet. I am having the same problem. I am confused on this. I am in the exact same situation

  5. #5
    Sherryjean, unfortunately so I still have not had any other response to my issue. I am glad to see that someone else in the coding world is having the same concern, now I don't feel so alone....I guess I am going to write a letter to a group of Pulmonologist Drs. in our area and see if they can give me some guideance. Once I hear from them I will let you know....do you have a email I could send any correspondence to?

  6. #6
    Ruthan and Sherryjean, I am wondering if you had heard anything back on this? I have recently taken over the Sleep portion of our practice and am looking for any and all information that is useful! I'm wondering if you may also know of a resource for Sleep billers or any seminars? Maybe we can band together and share information?!

  7. #7

    Thanks for your post, I am sorry to say that I do not have any information yet on the OSA diagnosis but am still working on it. As soon as I find something out I will most surely post on it. I will also see if I come across any thing billing related or any seminars etc. for you and let you know.

  8. #8
    St. Louis West, MO
    Default OSA versus sleep apnea
    If it says Obstructive Sleep Apnea (OSA) you code 327.23. See vj_tiwari post for etiology and physiology. Obstructive sleep apnea IS an organic disorder because the patient's own soft tissues are obstructing the flow of air when they are asleep, which can cause all sorts of problems from fatigue to heart problems.

    If it says sleep apnea only it's 780.57, which is a symptom code, meaning there is no cause identified yet.

    Hope that helps.

    Serine, CPC

  9. #9
    Thank you Serine for your information....I have not had the proper time to follow up with the letter to our Specialists yet but this helps alot.

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