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F51

Non-Billable (Header)

Sleep disorders not due to a substance or known physiological condition

Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)

What This Code Means

F51 is the ICD-10-CM diagnosis code for sleep disorders not due to a substance or known physiological condition. F51 sits in the ICD-10-CM chapter for mental, behavioral and neurodevelopmental disorders (f01-f99), within the section covering behavioral syndromes associated with physiological disturbances and physical factors (f50-f59).

Header codes like F51 cannot be reported on claims directly — they organize child codes that share clinical context but the actual diagnosis must be coded to the highest level of specificity supported by the documentation. Coders should look at F51's child codes and select the one that matches the patient's documented presentation, since payers reject header codes submitted as the primary diagnosis. For risk adjustment workflows, header codes never contribute to a Medicare Advantage member's RAF score on their own; only billable child codes that happen to map to a payment HCC affect risk-adjusted plan payments.

HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for F51 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Excludes 2 — Not included here, may code separately

  • organic sleep disorders (G47.-)

Child Codes

Code Hierarchy

F51Sleep disorders not due to a substance or known physiological condition
F51Sleep disorders not due to a substance or known physiological condition

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