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Sleep apnea: when is it appropriate to use `780.57`?

Kathy Posted Fri 17th of June, 2011 20:22:09 PM

If a patient has a sleep study, for which s/he does not meet the criteria for obstructive sleep apnea (15 AHI or 5 AHI with certain symptoms) but does have some apneic events, would it be appropriate to code 780.57?

When a patient comes in for a New Patient visit and their parent/spouse describes witnessed apneic events, but a sleep study has not yet been performed, is it appropriate to code 780.57?

Thanks for your help!

Erin

SuperCoder Answered Fri 17th of June, 2011 21:34:02 PM

1st question:
Obstructive sleep apnea is coded as 327.23. The sleep study doesn't meet the criteria of Obstructive sleep apnea, so we CAN'T code Obstructive sleep apnea here. As some apneic events occurred during sleep study, so we can code 780.57. If apneic events occurred not during sleep study, then we need to code for apnea only: 786.03
2nd question:
Since sleep study was not performed, then we need to code for the complaints, i.e; apnea only: 786.03

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