ICD-10-CM 2026 · Effective October 1, 2025

ICD-10 F51.12

Billable / Specific

Insufficient sleep syndrome

F51
Block
0
Synonyms
236
LCDs
10
Payer Policies
0
Linked CPTs

About ICD-10-CM F51.12

ICD-10-CM code F51.12 represents Insufficient sleep syndrome. This is a billable/specific code in the Mental, Behavioral, and Neurodevelopmental chapter (block F51). The 2026 edition of ICD-10-CM F51.12 became effective on October 1, 2025.

Type 1 Excludes

Pure excludes, these codes can never be coded together with F51.12. The conditions are mutually exclusive (e.g., congenital vs acquired forms).

  • sleep deprivation (Z72.820)

Medicare LCD Coverage for F51.12

Local Coverage Determinations (LCDs) from CMS MACs that list F51.12 as a covered diagnosis.

236 LCDs

Showing top 10 of 236 total . Click a CPT for full coverage scope.

CMS LCD: Billing and Coding: Psychiatric Inpatient Hospitalization
Article ID: 57052, Effective: 2026-03-26 00:00:00, 422 covered, 0 non-covered
CPT XX000 →
CMS LCD: Billing and Coding: Psychiatric Diagnostic Evaluation and Psychotherapy Services
Article ID: 57520, Effective: 2025-01-01 00:00:00, 582 covered, 1 non-covered
CPT 90847 →
CMS LCD: Billing and Coding: Psychiatric Diagnostic Evaluation and Psychotherapy Services
Article ID: 57520, Effective: 2025-01-01 00:00:00, 582 covered, 1 non-covered
CPT G0560 →
CMS LCD: Billing and Coding: Psychiatric Diagnostic Evaluation and Psychotherapy Services
Article ID: 57520, Effective: 2025-01-01 00:00:00, 582 covered, 1 non-covered
CPT G0017 →
CMS LCD: Billing and Coding: Psychiatric Diagnostic Evaluation and Psychotherapy Services
Article ID: 57520, Effective: 2025-01-01 00:00:00, 582 covered, 1 non-covered
CPT 90837 →
CMS LCD: Billing and Coding: Psychiatric Diagnostic Evaluation and Psychotherapy Services
Article ID: 57520, Effective: 2025-01-01 00:00:00, 582 covered, 1 non-covered
CPT 90792 →
CMS LCD: Billing and Coding: Psychiatric Diagnostic Evaluation and Psychotherapy Services
Article ID: 57520, Effective: 2025-01-01 00:00:00, 582 covered, 1 non-covered
CPT 90791 →
CMS LCD: Billing and Coding: Psychiatric Diagnostic Evaluation and Psychotherapy Services
Article ID: 57520, Effective: 2025-01-01 00:00:00, 582 covered, 1 non-covered
CPT 90833 →
CMS LCD: Billing and Coding: Psychiatric Diagnostic Evaluation and Psychotherapy Services
Article ID: 57520, Effective: 2025-01-01 00:00:00, 582 covered, 1 non-covered
CPT 90845 →
CMS LCD: Billing and Coding: Psychiatric Diagnostic Evaluation and Psychotherapy Services
Article ID: 57520, Effective: 2025-01-01 00:00:00, 582 covered, 1 non-covered
CPT 90840 →

Commercial Payer Coverage

Coverage policies from major commercial payers referencing F51.12.

10 policies

5 Medicare

Billing and Coding: Outpatient Sleep Studies
Policy ID: ART-56923
Billing and Coding: Psychiatry and Psychology Services
Policy ID: ART-56937
Billing and Coding: Psychiatric Inpatient Hospitalization
Policy ID: ART-57052
Billing and Coding: Psychiatric Partial Hospitalization Programs
Policy ID: ART-57053
Billing and Coding: Outpatient Psychiatry and Psychology Services
Policy ID: ART-57065

CPT Codes Commonly Billed with F51.12

Procedures frequently paired with this diagnosis based on PayerReady's Dx↔Px linkage data.

No procedure linkages on file for F51.12

We don't have CPT pairings indexed for this specific code yet. Use the CPT search above to find common procedures, or check your payer's published medical policy for code-specific guidance.

Convert F51.12 to ICD-9-CM

Per CMS General Equivalence Mappings (GEMs), useful for legacy data review and historical claim analysis.

ICD-10ICD-9Mapping Flags
F51.12 30744 10000

Flags format (5 digits): Approximate · No Map · Combination · Scenario · Choice List. Source: CMS 2017 GEMs (final version).

ICD-10 F51.12, Billing FAQ

Is ICD-10 code F51.12 billable? +

Yes, F51.12 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.

What codes are Type 1 Excludes for F51.12? +

Type 1 Excludes (never code together with F51.12): sleep deprivation (Z72.820)

What ICD-9 codes does F51.12 map to? +

Per CMS GEMs, F51.12 maps to ICD-9 codes: 30744. Useful for legacy data review and historical claim analysis.

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Reviewed by the PayerReady Medical Coding Team

Verified against the CMS 2026 code set on May 31, 2026.

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