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CBT-I can be indicated for both primary and secondary insomnia. It primarily focuses on how patients deal with acute insomnia symptoms and how these symptoms are maintained and become chronic. These maintaining factors are often relevant in both primary and secondary insomnia. [16] [non-primary source needed]
The International Classification of Diseases (ICD-9-CM and ICD-10-CM) codes corresponding to each specific diagnosis can be found within the ICSD-3. [5] Furthermore, pediatric diagnoses are not distinguished from adult diagnoses except for sleep-related breathing disorders.
The axial system uses International Classification of Diseases (ICD-9- CM) coding wherever possible. Additional codes are included for procedures and physical signs of particular interest to sleep disorders clinicians and researchers. Diagnoses and procedures are listed and coded on three main "axes." The axial system is arranged as follows: [16]
Complex or multicomponent interventions use multiple strategies, [5] and they often involve the participation of several types of care providers. [6] Non-pharmacological interventions can call on various fields of expertise, such as surgery, medical devices, rehabilitation, psychotherapy, and behavioral interventions. [6]
The DSM-5 (2013), the current version, also features ICD-9-CM codes, listing them alongside the codes of Chapter V of the ICD-10-CM. On 1 October 2015, the United States health care system officially switched from the ICD-9-CM to the ICD-10-CM. [1] [2] The DSM is the authoritative reference work in diagnosing mental disorders in the world.
Insomnia disorder (primary insomnia), chronic difficulty in falling asleep or maintaining sleep when no other cause is found for these symptoms. Insomnia can also be comorbid with or secondary to other disorders. Kleine–Levin syndrome, a rare disorder characterized by persistent episodic hypersomnia and cognitive or mood changes [84]
It is different from treatment of insomnia, and recognizes the patients' ability to sleep well on their own schedules, while addressing the timing problem. Success, if any, may be partial; for example, a patient who normally awakens at noon may only attain a wake time of 10 or 10:30 with treatment and follow-up.
Prior to the introduction of this code, the nonspecific code 307.45, Circadian rhythm sleep disorder of non-organic origin, was available, and as of 2014 remains the code recommended by the DSM-5. ICD-10-CM: Circadian rhythm sleep disorder, free running type; code G47.24 was due to take effect October 1, 2014.