Restless Leg Syndrome (RLS) is a common neurological sleep disorder characterized by an irresistible urge to move the legs. This urge is often accompanied by uncomfortable sensations, such as creeping or tingling. Symptoms typically emerge or intensify during periods of rest or inactivity, especially in the evening or at night. Standardized classification systems are necessary for accurate medical records, insurance processing, and public health tracking. A specific code is assigned to RLS to allow medical professionals to uniformly identify and document the condition for administrative and research purposes.
What is the ICD-10 Coding System?
The International Classification of Diseases, Tenth Revision (ICD-10) is a global standard established by the World Health Organization (WHO) for classifying diseases and other health problems. This extensive system standardizes the collection and presentation of medical data, allowing researchers and health officials to compare health trends worldwide. The primary goal of the ICD-10 is to move from a descriptive diagnosis to a universally recognizable alphanumeric code.
Every code is composed of three to seven characters, starting with a letter followed by numbers. The initial characters denote the disease chapter and category, progressively adding detail with each subsequent character. Healthcare providers rely on these codes for clinical documentation and administrative functions, including patient billing and insurance reimbursement.
Identifying the Specific Code for Restless Leg Syndrome
The primary ICD-10 code utilized for Restless Leg Syndrome is G25.81. This code is categorized within the chapter dedicated to Diseases of the Nervous System.
The “G25” portion signifies “Other extrapyramidal and movement disorders,” classifying RLS as a neurological motor disturbance. The final characters, “.81,” specify the diagnosis as Restless Leg Syndrome, distinguishing it from other conditions in the G25 category. G25.81 covers both primary (idiopathic) RLS and secondary RLS, which is linked to underlying conditions. While secondary RLS may require an additional code for the underlying cause, G25.81 remains the specific label for the RLS symptoms.
How the RLS Diagnosis is Coded
Healthcare providers assign the G25.81 code only after a patient’s symptoms align with specific clinical criteria. Diagnosis relies primarily on a detailed interview and the patient’s description of symptoms, as no single laboratory test exists for RLS. The core diagnostic requirements were developed by the International Restless Legs Syndrome Study Group (IRLSSG).
The physician must confirm the presence of four key criteria:
- The patient must report an urge to move the legs, frequently accompanied by uncomfortable sensations.
- The urge must begin or worsen during periods of rest or inactivity, such as sitting or lying down.
- Symptoms must be partially or completely relieved by movement, such as walking or stretching.
- Symptoms are worse in the evening or at night than during the day, following a distinct circadian pattern.