Skip to main content

F51.09 ICD-10-CM Code: Other insomnia not due to a substance or known physiological condition

Billing Status: YES. This is a valid, specific, and billable ICD-10-CM reference.

Coding at a Glance

Tabular directives
7 Excludes2

Inpatient Payment Groups (MS-DRG)

Potential MS-DRG participation — not a DRG assignment.

MS-DRGs this diagnosis helps define, as principal or secondary, per the CMS ICD-10-CM/PCS MS-DRG Definitions Manual v43, Appendix B.

  • MS-DRG 887 — OTHER MENTAL DISORDER DIAGNOSES (MDC 19)

A diagnosis appearing in a group's logic does not by itself determine the DRG assigned to a stay; the grouper uses the full claim.

Coding instructions

Official Tabular Instructional Notes: the inclusion, exclusion and sequencing notes published for F51.09 in the official ICD-10-CM tabular list, quoted as published.

Notes without a marker are published on F51.09 itself; “inherited from” names the category or block whose note applies here.

Excludes2 — Not Included Here

Conditions not covered by this code, but which may be reported alongside it when both are present.

Coder workflow for F51.09

MedCoder structured workflow — derived from this code’s own official record

Before you code F51.09

  1. “Other” (NEC) means the condition is specified in the record but no dedicated code captures it. Confirm the documented form is not one a sibling code names before settling on F51.09; if the record states no specifics at all, the unspecified sibling applies instead. “Other” codes are for documented conditions the classification gives no specific code; “unspecified” codes are for records lacking the detail (Guidelines I.A.9.a, I.A.9.b).

    ReviewF51.01, F51.02, F51.03, F51.04, F51.05

    See the relationships section · Guide: Other vs unspecified (NEC vs NOS) →

  2. F51.09’s title joins a condition with an associated condition or complication. Confirm each component is documented. Where the classification presumes the link through the “with” convention, only a provider statement that the conditions are unrelated defeats it. A combination code is assigned only when it fully identifies the documented conditions; a required second code for the stage, type or manifestation is still reported when the notes ask for it (Guidelines I.B.9, I.A.15).

    Guide: Combination codes →

Documentation check

The provider’s diagnostic statement
Codes are assigned from the provider’s documented diagnosis, not from clinical criteria, test values or a medication list (Guidelines I.A.19).
The associated condition or complication
Whether the associated condition the title names is documented; the “with” convention presumes some links, and a provider statement that the conditions are unrelated defeats it (Guidelines I.A.15).
Any detail beyond this code’s title
What the record states that a more specific sibling code would capture — or its absence, which itself supports the unspecified code.

Official instructions as workflow

Coding decision scenarios

Pattern scenarios for this code’s structure — decision rules, not clinical cases

Documentation: Only one of the components this code’s title joins is documented.

Coding question: Is F51.09 supported?

Path: Review the code for the documented component on its own.

Reason: A combination code is assigned only when it fully identifies the documented conditions; otherwise the documented component takes its own code (Guidelines I.B.9).

Every row is derived from this code’s own record — its title, tabular notes, 7th-character family and same-category siblings — with fixed MedCoder wording; nothing is inferred about a patient. The official notes and guideline text are in the sections each row links to, and they control.

Code Overview

Other insomnia not due to a substance or known physiological condition is a billable ICD-10-CM diagnosis code (F51.09).

MedCoder summary Summary composed by MedCoder from this code's official ICD-10-CM record. The tabular instructional notes themselves appear verbatim below.

Indexed Clinical Terms (1)

Official source data — entries quoted as published, in the Index’s own lookup phrasing

Clinical term phrases from the official ICD-10-CM Index to Diseases and Injuries that map to this code. These are alphabetic-index entries shown as the Index writes them — lookup phrasing, not necessarily the wording of a final diagnosis.

Verify Before Coding

  • No Medicare Code Editor or MS-DRG Definitions Manual restrictions apply to this code.

From the code registry, the Medicare Code Editor, and the MS-DRG Definitions Manual. Check it against a full claim in Claim Check.

Relationships & Classification

MedCoder structured relationships — computed from published CMS and AHRQ datasets

Other codes that name F51.09 or its code family, from the CMS ICD-10-CM tabular instructional notes. Tabular-note edges are stored at the code family level that carries each note.

Referenced by 1 Excludes1 note: Z72.821 — Inadequate sleep hygiene (via F51.0.-).

These codes’ tabular lists mark this diagnosis as mutually exclusive — not reported together unless the conditions are documented as unrelated.

Referenced by 3 Excludes2 notes across 2 chapters: F98 — Other behavioral and emotional disorders with onset usually occurring in childhood and adolescence (via F51.-), G47 — Sleep disorders (via F51.-), G47.0 — Insomnia (via F51.0.-).

These codes’ tabular lists name this diagnosis as distinct — both may be reported when both are documented.

MS-DRG Grouper Relationships (FY2026)

Potential MS-DRG participation — not a DRG assignment.

Not on the CMS CC/MCC list — as a secondary diagnosis this code does not change MS-DRG severity.

Named in the grouper logic of 1 MS-DRG: DRG 887 (MDC 19).

From the CMS MS-DRG Definitions Manual (Appendices B and C). Actual DRG assignment depends on the complete claim.

Clinical classification (AHRQ CCSR):NVS016 — Sleep wake disorders (default).

Clinical Classifications Software Refined (CCSR) for ICD-10-CM Diagnoses. Healthcare Cost and Utilization Project (HCUP), Agency for Healthcare Research and Quality.

Related Codes

Same clinical category (CCSR)

AHRQ's Clinical Classifications Software groups these diagnoses under the same clinical category (Sleep wake disorders).

F19.182 — Other psychoactive substance abuse with psychoactive substance-induced sleep disorder, F19.282 — Other psychoactive substance dependence with psychoactive substance-induced sleep disorder, F19.982 — Other psychoactive substance use, unspecified with psychoactive substance-induced sleep disorder, F51.01 — Primary insomnia, F51.02 — Adjustment insomnia, F51.03 — Paradoxical insomnia, F51.04 — Psychophysiologic insomnia, F51.05 — Insomnia due to other mental disorder, F51.11 — Primary hypersomnia, F51.12 — Insufficient sleep syndrome, F51.13 — Hypersomnia due to other mental disorder, F51.19 — Other hypersomnia not due to a substance or known physiological condition, F51.3 — Sleepwalking [somnambulism], F51.4 — Sleep terrors [night terrors], F51.5 — Nightmare disorder, F51.8 — Other sleep disorders not due to a substance or known physiological condition, F51.9 — Sleep disorder not due to a substance or known physiological condition, unspecified, G25.81 — Restless legs syndrome, G47.00 — Insomnia, unspecified, G47.01 — Insomnia due to medical condition, +42 more

Same Index main term, other category

The ICD-10-CM Index to Diseases and Injuries files this code under the main term “Insomnia”; these codes share that main term but sit in a different category of the Tabular List.

F11.982 — Opioid use, unspecified with opioid-induced sleep disorder (due to, opioid, use), F13.182 — Sedative, hypnotic or anxiolytic abuse with sedative, hypnotic or anxiolytic-induced sleep disorder (due to, sedative, hypnotic, or anxiolytic, abuse), F13.282 — Sedative, hypnotic or anxiolytic dependence with sedative, hypnotic or anxiolytic-induced sleep disorder (due to, sedative, hypnotic, or anxiolytic, dependence), F13.982 — Sedative, hypnotic or anxiolytic use, unspecified with sedative, hypnotic or anxiolytic-induced sleep disorder (due to, sedative, hypnotic, or anxiolytic, use), F14.182 — Cocaine abuse with cocaine-induced sleep disorder (due to, cocaine, abuse), F14.282 — Cocaine dependence with cocaine-induced sleep disorder (due to, cocaine, dependence), F14.982 — Cocaine use, unspecified with cocaine-induced sleep disorder (due to, cocaine, use), F15.182 — Other stimulant abuse with stimulant-induced sleep disorder (due to, caffeine, abuse), F15.282 — Other stimulant dependence with stimulant-induced sleep disorder (due to, caffeine, dependence), F15.982 — Other stimulant use, unspecified with stimulant-induced sleep disorder (due to, caffeine, use), F19.182 — Other psychoactive substance abuse with psychoactive substance-induced sleep disorder (due to, drug NEC, abuse), F19.282 — Other psychoactive substance dependence with psychoactive substance-induced sleep disorder (due to, drug NEC, dependence), F19.982 — Other psychoactive substance use, unspecified with psychoactive substance-induced sleep disorder (due to, drug NEC, use), G47.00 — Insomnia, unspecified, G47.01 — Insomnia due to medical condition (due to, medical condition), G47.09 — Other insomnia (specified NEC), Z73.810 — Behavioral insomnia of childhood, sleep-onset association type (behavioral, of childhood, sleep-onset association type), Z73.811 — Behavioral insomnia of childhood, limit setting type (behavioral, of childhood, limit setting type), Z73.812 — Behavioral insomnia of childhood, combined type (behavioral, of childhood, combined type), Z73.819 — Behavioral insomnia of childhood, unspecified type (childhood), +6 more

Contextual Map

Every relationship of F51.09 in one view: hierarchy, official tabular instructions in both directions, clinical classification, risk adjustment, MS-DRG participation, index terms and change history — each edge carrying the CMS source it derives from.

Run F51.09 with these 4 related codes in Claim Check

Hierarchy

Referenced by Excludes1 notes

Referenced by Excludes2 notes

Clinical classification (CCSR)

MS-DRG Grouper

MDC crossing

  • MDC 19 — Mental Diseases and Disorders[MDC crossing]: “Mental Diseases and Disorders — the grouper's crossing between diagnoses and procedures: a principal diagnosis sets the MDC, and same-MDC procedures move the stay to its surgical DRGs.”— CMS MS-DRG Definitions Manual · FY2026

Index entries

  • Insomnia (organic), not due to a substance or known physiological condition, specified NEC[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026

Nearest codes (17)

Change history

  • FY2016 — In the code set at ICD-10-CM adoption [Change history]— CMS release files (code change ledger) · icd10cm-fy2016

Sources for this page

Codes, titles, notes, index terms and mappings on this page are transcribed from the datasets below. Relationships MedCoder computed and text MedCoder wrote are labelled where they appear.

Code, title, tabular notes and index terms Official source data
CMS/CDC ICD-10-CM FY2026 tabular list, index and tables, effective October 1, 2025 Release, file and checksum · Publisher’s page
Claim edits Official source data
CMS Definitions of Medicare Code Edits — v43.1 (April 2026) Release, file and checksum · Publisher’s page
Inpatient payment groups Official source data
CMS MS-DRG Definitions Manual (incl. Appendix B diagnosis index, Appendix C CC/MCC list, Appendix E procedure index) and IPPS Final Rule tables — v43 Release, file and checksum · Publisher’s page
Change history and date-of-service validity Official source data
CMS ICD-10-CM release addenda, ingested release by release into the change ledger Release, file and checksum · Publisher’s page
Comparisons, relationships and the contextual map MedCoder structured relationship
Computed by MedCoder from the tabular notes and tables above; every derived relationship is marked as derived where it appears
Summary and FAQ answers MedCoder explanation
Written by MedCoder to explain the sources above: drafted with AI assistance, checked by a person against the release files, and labelled as MedCoder text where it appears. Not official text.

Labels on this page: Official source data · MedCoder structured relationship · MedCoder explanation. How to read the labels · All data sources and release dates

Change history

  • FY2016 — October 1, 2015
    In the code set at ICD-10-CM adoption
    Other insomnia not due to a substance or known physiological condition

No changes since FY2016 — additions, deletions, description changes and billable-status changes are tracked through FY2027 (effective October 1, 2026), and none are recorded for this code. Note changes are tracked from FY2027 only.

Nearest Codes in This Family

Official ICD-10-CM classifications closest to F51.09 in its code family, with their registry titles.

View all codes in the F51 family