F51.03 — Paradoxical insomnia
F51.03 is a billable, specific ICD-10-CM code for paradoxical insomnia. It is valid for submission on a claim.
Excludes2 inherited from the categories above F51.03
Also inherited, and the opposite of Excludes1: these conditions are not part of F51.03, but a patient can have both, so you may code both.
Written on F51.0 — Insomnia not due to a substance or known physiological condition
- alcohol related insomnia (F10.182, F10.282, F10.982)
- drug-related insomnia (F11.182, F11.282, F11.982, F13.182, F13.282, F13.982, F14.182, F14.282, F14.982, F15.182, F15.282, F15.982, F19.182, F19.282, F19.982)
- insomnia NOS (G47.0-)
- insomnia due to known physiological condition (G47.0-)
- organic insomnia (G47.0-)
- sleep deprivation (Z72.820)
Risk adjustment
F51.03 does not map to an HCC and does not risk-adjust under CMS-HCC V28. That is normal — most ICD-10 codes do not. It still needs to be coded correctly; it just will not move a RAF score.
Medicare coverage
F51.03 is named in 12 Medicare coverage policies — 10 listing it as supporting medical necessity, and 2 listing it as NOT covered. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.
- A52434Health and Behavior Assessment/Intervention – Medical Policy Articlenot covered
- A56865Billing and Coding: Psychiatric Inpatient Hospitalizationnot covered
- A56923Billing and Coding: Outpatient Sleep Studies
- A56937Billing and Coding: Psychiatry and Psychology Services
How F51.03 is indexed
Coders do not find codes by browsing the tabular list — they look them up in the alphabetic index, under the word the physician wrote. These are the index entries that lead here, so you can see which chart wordings map to F51.03.
- Pseudoinsomnia
- Hypochondria, hypochondriac, hypochondriasis›sleep
- Insomnia›paradoxical
Code history
F51.03 has not changed since FY2024 — no addition, revision or deletion across the three most recent ICD-10-CM releases.
Related codes at this level
Codes that share F51.0. If F51.03 is not quite right, the correct code is usually one of these.
Questions about F51.03
- Is F51.03 a billable ICD-10-CM code?
- Yes. F51.03 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does F51.03 sit in the tabular list?
- Mental, Behavioral and Neurodevelopmental disorders (F01-F99), in the block Behavioral syndromes associated with physiological disturbances and physical factors (F50-F59).