CPT 95801: ICD-10 codes that support medical necessity
These ICD-10-CM diagnoses support medical necessity for CPT 95801 under Medicare coverage policies (LCDs, NCDs, and Billing & Coding articles). Billing CPT 95801 with a diagnosis that isn't covered typically denies as CARC 50 — not medically necessary.
National approximation. Coverage varies by MAC and state — confirm against the specific LCD/NCD and article that applies to your jurisdiction and date of service.
| ICD-10 | Description |
|---|---|
| E66.2 | Morbid (severe) obesity with alveolar hypoventilation |
| F10.182 | Alcohol abuse with alcohol-induced sleep disorder |
| F10.282 | Alcohol dependence with alcohol-induced sleep disorder |
| F10.982 | Alcohol use, unspecified with alcohol-induced sleep disorder |
| F11.182 | Opioid abuse with opioid-induced sleep disorder |
| F11.282 | Opioid dependence with opioid-induced sleep disorder |
| F11.982 | Opioid use, unspecified with opioid-induced sleep disorder |
| F13.182 | Sedative, hypnotic or anxiolytic abuse with sedative, hypnotic or anxiolytic-induced sleep disorder |
| F13.282 | Sedative, hypnotic or anxiolytic dependence with sedative, hypnotic or anxiolytic-induced sleep disorder |
| F13.982 | Sedative, hypnotic or anxiolytic use, unspecified with sedative, hypnotic or anxiolytic-induced sleep disorder |
| F14.182 | Cocaine abuse with cocaine-induced sleep disorder |
| F14.282 | Cocaine dependence with cocaine-induced sleep disorder |
| F14.982 | Cocaine use, unspecified with cocaine-induced sleep disorder |
| F15.182 | Other stimulant abuse with stimulant-induced sleep disorder |
| F15.282 | Other stimulant dependence with stimulant-induced sleep disorder |
| F15.982 | Other stimulant use, unspecified with stimulant-induced sleep disorder |
| F19.182 | Other psychoactive substance abuse with psychoactive substance-induced sleep disorder |
| F19.21 | Other psychoactive substance dependence, in remission |
| 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 |
| F51.09 | Other insomnia not due to a substance or known physiological condition |
| 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 |
| 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 |
| G47.23 | Circadian rhythm sleep disorder, irregular sleep wake type |
| G47.24 | Circadian rhythm sleep disorder, free running type |
| G47.25 | Circadian rhythm sleep disorder, jet lag type |
| G47.26 | Circadian rhythm sleep disorder, shift work type |
| G47.27 | Circadian rhythm sleep disorder in conditions classified elsewhere |
| G47.29 | Other circadian rhythm sleep disorder |
| G47.30 | Sleep apnea, unspecified |
| G47.31 | Primary central sleep apnea |
| G47.32 | High altitude periodic breathing |
| G47.33 | Obstructive sleep apnea (adult) (pediatric) |
| G47.34 | Idiopathic sleep related nonobstructive alveolar hypoventilation |
| G47.35 | Congenital central alveolar hypoventilation syndrome |
| G47.36 | Sleep related hypoventilation in conditions classified elsewhere |
| G47.37 | Central sleep apnea in conditions classified elsewhere |
| G47.39 | Other sleep apnea |
| G47.411 | Narcolepsy with cataplexy |
| G47.419 | Narcolepsy without cataplexy |
| G47.421 | Narcolepsy in conditions classified elsewhere with cataplexy |
| G47.429 | Narcolepsy in conditions classified elsewhere without cataplexy |
| G47.50 | Parasomnia, unspecified |
| G47.51 | Confusional arousals |
| G47.52 | REM sleep behavior disorder |
| G47.53 | Recurrent isolated sleep paralysis |
| G47.54 | Parasomnia in conditions classified elsewhere |
| G47.59 | Other parasomnia |
| G47.61 | Periodic limb movement disorder |
| G47.69 | Other sleep related movement disorders |
| G47.8 | Other sleep disorders |
| G47.9 | Sleep disorder, unspecified |
| N52.01 | Erectile dysfunction due to arterial insufficiency |
| N52.02 | Corporo-venous occlusive erectile dysfunction |
| N52.03 | Combined arterial insufficiency and corporo-venous occlusive erectile dysfunction |
| N52.1 | Erectile dysfunction due to diseases classified elsewhere |
| N52.2 | Drug-induced erectile dysfunction |
| N52.31 | Erectile dysfunction following radical prostatectomy |
| N52.32 | Erectile dysfunction following radical cystectomy |
| N52.33 | Erectile dysfunction following urethral surgery |
| N52.34 | Erectile dysfunction following simple prostatectomy |
| N52.35 | Erectile dysfunction following radiation therapy |
| N52.36 | Erectile dysfunction following interstitial seed therapy |
| N52.37 | Erectile dysfunction following prostate ablative therapy |
| N52.39 | Other and unspecified postprocedural erectile dysfunction |
| N52.8 | Other male erectile dysfunction |
| N52.9 | Male erectile dysfunction, unspecified |
| R06.83 | Snoring |
| R09.02 | Hypoxemia |
Frequently asked questions
Which ICD-10 codes support medical necessity for CPT 95801?
Medicare coverage policies (LCDs/NCDs and Billing & Coding articles) list 87 ICD-10 diagnosis codes that support medical necessity for CPT 95801. The covered codes are listed on this page. Coverage varies by MAC/state — always confirm against the policy that applies to you.
What is a medical-necessity (LCD/NCD) crosswalk?
A claim whose procedure isn't supported by a covered diagnosis denies as "not medically necessary" (CARC 50). CMS coverage policies define which diagnoses justify a procedure; this page is the ICD-10 → CPT 95801 view of that relationship.
More free billing tools: all crosswalks · NCCI edits · Medicare fees · denial codes
Informational only, not coding, billing, or legal advice. Based on CMS Medicare Coverage Database data; verify the current LCD/NCD for your MAC before billing.
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