Quick reference
- When to use
- Use G47.00 when the client meets criteria for Insomnia Disorder as defined in DSM-5. Confirm frequency and duration thresholds. Rule out substance effects and other sleep disorders before assigning.
- Duration
- Insomnia: 3+ nights per week for 3+ months. Document sleep patterns with sleep diary for at least 2 weeks before diagnosis. Reassess with sleep measures at regular intervals.
- Session codes
- Pair with CPT 90834 for CBT-I sessions (typically 4-8 sessions). 90791 for initial evaluation. 96127 for ISI (Insomnia Severity Index) screening. May coordinate with sleep medicine for polysomnography.
- Key indicators
- Sleep onset difficulty • Sleep maintenance difficulty • Early morning awakening • Daytime impairment • Adequate sleep opportunity present • Frequency and duration criteria met
What G47.00 represents
Insomnia disorder involves dissatisfaction with sleep quantity or quality, associated with difficulty initiating or maintaining sleep, or early morning awakening with inability to return to sleep. It occurs at least 3 nights per week for at least 3 months.
Key diagnostic criteria
- Dissatisfaction with sleep quantity/quality with 1+: difficulty initiating sleep, difficulty maintaining sleep, early-morning awakening
- Causes significant distress or impairment
- Occurs at least 3 nights/week
- Present for at least 3 months
- Occurs despite adequate sleep opportunity
- Not better explained by another sleep-wake disorder
Documentation essentials
Document sleep onset latency, wake after sleep onset, total sleep time, sleep quality, and daytime functioning impact.
Differential diagnosis
Rule out sleep apnea, restless legs syndrome, circadian rhythm disorders, substance effects, and parasomnias.
Treatment planning
CBT-I (Cognitive Behavioral Therapy for Insomnia) is first-line treatment. Sleep hygiene education. Medication as adjunct if needed.
Insurance & billing
Accepted code. Document frequency and duration requirements.
Updates & changes
DSM-5 elevated insomnia to a standalone diagnosis rather than secondary to other conditions.
Documentation pitfalls
Don't overlook comorbid conditions. Rule out other sleep disorders. Document adequate sleep opportunity.
References
- American Psychiatric Association. (2022). Diagnostic and Statistical Manual of Mental Disorders (5th ed., text rev.).