ICD-10 Code Z73.811
Behavioral insomnia of childhood, limit setting type
| ICD-10: | Z73.811 |
| Short Description: | Behavioral insomnia of childhood, limit setting type |
| Long Description: | Behavioral insomnia of childhood, limit setting type |
Valid for Submission
ICD-10 Z73.811 is a billable code used to specify a medical diagnosis of behavioral insomnia of childhood, limit setting type. The code is valid for the year 2019 for the submission of HIPAA-covered transactions.
Code Classification
- Factors influencing health status and contact with health services (Z00–Z99)
Information for Medical Professionals
Code Edits
The Medicare Code Editor (MCE) detects and reports errors in the coding of claims data. The following ICD-10 Code Edits are applicable to this code:
- Pediatric diagnoses - Pediatric. Age range is 0–17 years inclusive (e.g., Reye’s syndrome, routine child health exam).
- Unacceptable principal diagnosis - There are selected codes that describe a circumstance which influences an individual’s health status but not a current illness or injury, or codes that are not specific manifestations but may be due to an underlying cause. These codes are considered unacceptable as a principal diagnosis.
Convert Z73.811 to ICD-9
The following crosswalk between ICD-10 to ICD-9 is based based on the General Equivalence Mappings (GEMS) information:
- V69.5 - Behav insomnia-childhood (Approximate Flag)
Present on Admission (POA)
Z73.811 is exempt from POA reporting - The Present on Admission (POA) indicator is used for diagnosis codes included in claims involving inpatient admissions to general acute care hospitals. POA indicators must be reported to CMS on each claim to facilitate the grouping of diagnoses codes into the proper Diagnostic Related Groups (DRG). CMS publishes a listing of specific diagnosis codes that are exempt from the POA reporting requirement.
CMS POA Indicator Options and Definitions
| POA Indicator Code | POA Reason for Code | CMS will pay the CC/MCC DRG? |
|---|---|---|
| Y | Diagnosis was present at time of inpatient admission. | YES |
| N | Diagnosis was not present at time of inpatient admission. | NO |
| U | Documentation insufficient to determine if the condition was present at the time of inpatient admission. | NO |
| W | Clinically undetermined - unable to clinically determine whether the condition was present at the time of inpatient admission. | YES |
| 1 | Unreported/Not used - Exempt from POA reporting. | NO |
Synonyms
The following clinical terms are approximate synonyms:
- Behavioral insomnia of childhood
- Behavioral insomnia of childhood, limit setting type
- Limit-setting sleep disorder
Index to Diseases and Injuries
The Index to Diseases and Injuries is an alphabetical listing of medical terms, with each term mapped to one or more ICD-10 code(s). The following references for the code Z73.811 are found in the index:
- - Insomnia (organic) - G47.00
- - behavioral, of childhood - Z73.819
- - limit setting type - Z73.811
- - behavioral, of childhood - Z73.819
Information for Patients
Insomnia
What is insomnia?
Insomnia is a common sleep disorder. If you have it, you may have trouble falling asleep, staying asleep, or both. As a result, you may get too little sleep or have poor-quality sleep. You may not feel refreshed when you wake up.
What are the symptoms of insomnia?
Symptoms of insomnia include:
- Lying awake for a long time before you fall asleep
- Sleeping for only short periods
- Being awake for much of the night
- Feeling as if you haven't slept at all
- Waking up too early
What are the types of insomnia?
Insomnia can be acute (short-term) or chronic (ongoing). Acute insomnia is common. Common causes include stress at work, family pressures, or a traumatic event. It usually lasts for days or weeks.
Chronic insomnia lasts for a month or longer. Most cases of chronic insomnia are secondary. This means they are the symptom or side effect of some other problem, such as certain medical conditions, medicines, and other sleep disorders. Substances such as caffeine, tobacco, and alcohol can also be a cause.
Sometimes chronic insomnia is the primary problem. This means that it is not caused by something else. Its cause is not well understood, but long-lasting stress, emotional upset, travel and shift work can be factors. Primary insomnia usually lasts more than one month.
Who gets insomnia?
?Insomnia is common. It affects women more often than men. You can get it at any age, but older adults are more likely to have it. You are also at higher risk of insomnia if you
- Have a lot of stress
- Are depressed or have other emotional distress, such as divorce or death of a spouse
- Have a lower income
- Work at night or have frequent major shifts in your work hours
- Travel long distances with time changes
- Have an inactive lifestyle
- Are African American; research shows that African Americans take longer to fall asleep, don't sleep as well, and have more sleep-related breathing problems than whites.
What other problems can insomnia cause?
Insomnia can cause daytime sleepiness and a lack of energy. It also can make you feel anxious, depressed, or irritable. You may have trouble focusing on tasks, paying attention, learning, and remembering. Insomnia also can cause other serious problems. For example, it could make you may feel drowsy while driving. This could cause you get into a car accident.
How is insomnia diagnosed?
To diagnose insomnia, your health care provider
- Takes your medical history
- Asks for your sleep history. Your provider will ask you for details about your sleep habits.
- Does a physical exam, to rule out other medical problems that might cause insomnia
- May recommend a sleep study. A sleep study measures how well you sleep and how your body responds to sleep problems.
What are the treatments for insomnia?
Treatments include lifestyle changes, counseling, and medicines:
- Lifestyle changes, including good sleep habits, often help relieve acute (short-term) insomnia. These changes might make it easier for you to fall asleep and stay asleep.
- A type of counseling called cognitive-behavioral therapy (CBT) can help relieve the anxiety linked to chronic (ongoing) insomnia
- Several medicines also can help relieve your insomnia and allow you to re-establish a regular sleep schedule
If your insomnia is the symptom or side effect of another problem, it's important to treat that problem (if possible).
NIH: National Heart, Lung, and Blood Institute
- Changing your sleep habits (Medical Encyclopedia)
- Insomnia (Medical Encyclopedia)
- Medicines for sleep (Medical Encyclopedia)
[Read More]
ICD-10 Footnotes
General Equivalence Map Definitions
The ICD-10 and ICD-9 GEMs are used to facilitate linking between the diagnosis codes in ICD-9-CM and the new ICD-10-CM code set. The GEMs are the raw material from which providers, health information vendors and payers can derive specific applied mappings to meet their needs.
- Approximate Flag - The approximate flag is on, indicating that the relationship between the code in the source system and the code in the target system is an approximate equivalent.
- No Map Flag - The no map flag indicates that a code in the source system is not linked to any code in the target system.
- Combination Flag - The combination flag indicates that more than one code in the target system is required to satisfy the full equivalent meaning of a code in the source system.