Narcolepsy with cataplexy

This code identifies a chronic neurological disorder characterized by overwhelming daytime sleepiness and sudden, brief losses of muscle tone (cataplexy) triggered by strong emotions. Individuals experience an irresistible urge to sleep, often accompanied by vivid dreams and sleep paralysis. The cataplexy episodes are typically brief, lasting seconds to minutes, and consciousness is maintained.

Assign this code when documentation clearly indicates a diagnosis of narcolepsy with the presence of cataplexy. This diagnosis is typically established through a comprehensive sleep study (polysomnography) and a multiple sleep latency test (MSLT), along with a thorough clinical history. Look for physician notes explicitly stating "narcolepsy with cataplexy" or detailing symptoms consistent with both conditions.

• Ensure the medical record explicitly documents the presence of cataplexy; without it, a different narcolepsy code may be appropriate.
• Differentiate from other hypersomnias or sleep disorders where cataplexy is absent.
• Consider sequencing this as a primary diagnosis when it is the main reason for the encounter.