Skip to main content

G47.01 ICD-10-CM Code: Insomnia due to medical condition

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

Coding at a Glance

Tabular directives
12 Excludes2 · 1 code-also instruction

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 v44, 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 G47.01 in the official ICD-10-CM tabular list, quoted as published.

Source: CMS/CDC — ICD-10-CM Tabular ListRelease: FY2027Effective: October 1, 2026

Trace:FY2027 changesChange historyRelease, file and checksum

Notes without a marker are published on G47.01 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.

Code Also

Additional codes that may be required to fully describe the encounter.

  • associated medical condition

Coder workflow for G47.01

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

Before you code G47.01

  1. G47.01’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).

Official instructions as workflow

  • Excludes2 — not part of G47.01(12 notes)

    Coding workflow: The conditions named in this note are not included in G47.01. When the record documents both, both may be reported; the note is a boundary, not a prohibition.

    CompareF10.182, F10.282, F10.982, F11.182, F11.282, F11.982

    See the official tabular notes · Guidelines I.A.12.b

  • Code Also — related condition(1 note)

    Coding workflow: Review the related condition when both are documented and the instruction applies. A Code Also note does not fix sequencing; the order follows the circumstances of the encounter.

    See the official tabular notes · Guidelines I.A.17

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 G47.01 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.

Don’t confuse G47.01 with…

MedCoder analysis — pairs from this code’s official notes, distinctions written by MedCoder

The codes most likely to be picked instead of G47.01 — named in its own official notes, or sharing its laterality or encounter family — with what separates them and which documentation moves the case. Each links to the full comparison.

  • G47.00— Specificity relationship (Review)

    Overlapping diagnoses in the same category.

    Overlapping codes in the same category — the documentation decides which is the more specific fit.

    What moves you there: A record that documents no more than “Insomnia, unspecified” takes G47.00; specificity in the record moves it back here.

    Full comparison: G47.01 vs G47.00 →

  • F10.182— Excludes2 relationship (Informational)

    Distinct conditions — both may be reported.

    A distinct condition — both may be reported when both are documented.

    What moves you there: Documentation of alcohol related insomnia adds F10.182; it is not part of this code and both may be reported when both are documented.

    Full comparison: G47.01 vs F10.182 →

  • F10.282— Excludes2 relationship (Informational)

    Distinct conditions — both may be reported.

    A distinct condition — both may be reported when both are documented.

    What moves you there: Documentation of alcohol related insomnia adds F10.282; it is not part of this code and both may be reported when both are documented.

    Full comparison: G47.01 vs F10.282 →

  • F10.982— Excludes2 relationship (Informational)

    Distinct conditions — both may be reported.

    A distinct condition — both may be reported when both are documented.

    What moves you there: Documentation of alcohol related insomnia adds F10.982; it is not part of this code and both may be reported when both are documented.

    Full comparison: G47.01 vs F10.982 →

  • F11.182— Excludes2 relationship (Informational)

    Distinct conditions — both may be reported.

    A distinct condition — both may be reported when both are documented.

    What moves you there: Documentation of drug-related insomnia adds F11.182; it is not part of this code and both may be reported when both are documented.

    Full comparison: G47.01 vs F11.182 →

  • F11.282— Excludes2 relationship (Informational)

    Distinct conditions — both may be reported.

    A distinct condition — both may be reported when both are documented.

    What moves you there: Documentation of drug-related insomnia adds F11.282; it is not part of this code and both may be reported when both are documented.

    Full comparison: G47.01 vs F11.282 →

Relationships are read from this code's own official notes, its laterality siblings and its encounter family; the wording of each distinction is MedCoder editorial, and the documentation named in each “what moves you there” line is the official note phrase or sibling title itself. Source: CMS ICD-10-CM tabular instructional notes; ICD-10-CM Official Guidelines, Section I.A.12.a.

Code Overview

Insomnia due to medical condition is a billable ICD-10-CM diagnosis code (G47.01).

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 G47.01 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 2 Excludes1 notes: Z72.820 — Sleep deprivation (via G47.0.-), Z72.821 — Inadequate sleep hygiene (via G47.0.-).

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

Referenced by 2 Excludes2 notes: F51 — Sleep disorders not due to a substance or known physiological condition (via G47.-), F51.0 — Insomnia not due to a substance or known physiological condition (via G47.0.-).

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

MS-DRG Grouper Relationships (FY2027)

Potential MS-DRG participation — not a DRG assignment.

FY2027 MS-DRG: not on the CMS CC/MCC list — as a secondary diagnosis this code does not change MS-DRG severity for that release.

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).

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, G47.09 — Other insomnia, G47.10 — Hypersomnia, unspecified, G47.11 — Idiopathic hypersomnia with long sleep time, G47.12 — Idiopathic hypersomnia without long sleep time, G47.13 — Recurrent hypersomnia, G47.14 — Hypersomnia due to medical condition, G47.19 — Other hypersomnia, G47.20 — Circadian rhythm sleep disorder, unspecified type, G47.21 — Circadian rhythm sleep disorder, delayed sleep phase type, G47.22 — Circadian rhythm sleep disorder, advanced sleep phase type, +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.

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), F51.01 — Primary insomnia (primary), F51.02 — Adjustment insomnia (transient), F51.03 — Paradoxical insomnia (paradoxical), F51.04 — Psychophysiologic insomnia (chronic), F51.05 — Insomnia due to other mental disorder (psychiatric), F51.09 — Other insomnia not due to a substance or known physiological condition (not due to a substance or known physiological condition, specified NEC), F51.3 — Sleepwalking [somnambulism] (learned), 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), +10 more

Lab tests where this diagnosis supports Medicare coverage (NCD)

Medicare's National Coverage Determination (NCD) program lists this diagnosis as medical justification for these lab tests.

Thyroid Stimulating Hormone (TSH)

Contextual Map

Every relationship of G47.01 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 G47.01 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 · FY2027

Index entries

  • Insomnia (organic), due to, medical condition[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026

Nearest codes (40)

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 FY2027 tabular list, index and tables, effective October 1, 2026 Release, file and checksum · Publisher’s page
Claim edits Official source data
CMS Definitions of Medicare Code Edits — v44.0 (October 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 — v44 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

Cite this page

Reference this page in a research guide, syllabus or article. The release is included because code content changes each year.

MedCoder.ai. "G47.01 — Insomnia due to medical condition." ICD-10-CM FY2027. https://medcoder.ai/icd10/code/g47.01-insomnia-due-to-medical-condition

Change history

  • FY2016 — October 1, 2015
    In the code set at ICD-10-CM adoption
    Insomnia due to medical condition

No changes since FY2016 — additions, deletions, description changes and billable-status changes are tracked through FY2027, 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 G47.01 in its code family, with their registry titles.

View all codes in the G47 family