ICD-10 Code F51.04 – Psychophysiologic insomnia (2026): Diagnosis, Symptoms & Billing Guide
2026 ICD-10-CM Diagnosis Code F51.04 – Psychophysiologic insomnia
What it is
Psychophysiologic insomnia is a sleep disorder in which difficulty falling asleep or staying asleep becomes linked to learned arousal and worry about sleep. The pattern is often self-perpetuating: you expect poor sleep, which makes sleep harder.
Clinical signs
Typical features include prolonged sleep latency, frequent awakenings, and difficulty returning to sleep. Clinical features vary; refer to documentation, especially when notes describe sleep-related anxiety, conditioned arousal, or persistent insomnia despite adequate opportunity to sleep.
When to use this code
Use F51.04 when the provider specifically documents psychophysiologic insomnia or equivalent phrasing such as insomnia driven by worry, tension, or conditioned sleep difficulty. It may also fit when the record clearly identifies a behavioral or emotional component to chronic insomnia. Check documentation if the note only says “insomnia” without type.
Do not use for
Do not use this code for insomnia due to a medical condition, medication, substance use, or another specified sleep disorder. If the documentation does not support psychophysiologic insomnia, select the more accurate insomnia code. Check documentation.
Coding tip
Code F51.04 only when the provider links insomnia to psychophysiologic factors; otherwise, use the unspecified insomnia code supported by the note.