Substance/Medication-Induced Sleep Disorder 415
Recording Procedures
ICD-9-CM. The name of the substance/medication-induced sleep disorder begins with
the specific substance (e.g., cocaine, bupropion)  that is presumed to be causing the sleep
disturbance. The diagnostic code is selected from the table included in the criteria set,
which is based on the drug class. For substances  that do not fit into any of the classes (e.g.,
bupropion), the code for “other substance” should be used; and in cases in which a sub-
stance is judged to be an etiological factor but the specific class of substance is unknown,
the category “unknown substance” should be used.
The name of the disorder is followed by the sp ecification of onset (i.e., onset during in-
toxication, onset during discontinuation/withdrawal), followed by the subtype designa-
tion (i.e., insomnia type, daytime sleepine ss type, parasomnia type, mixed type). Unlike
the recording procedures for ICD-10-CM, wh ich combine the substance-induced disorder
and substance use disorder into a single code, for ICD-9-CM a separate diagnostic code
is given for the substance use disorder. For ex ample, in the case of insomnia occurring
during withdrawal in a man with a severe lorazepam use disorder, the diagnosis is 292.85
lorazepam-induced sleep disorder, with onset during withdrawal, insomnia type. An ad-
ditional diagnosis of 304.10 severe lorazepam us e disorder is also given. When more than
one substance is judged to play a significant role in the developmen t of the sleep distur-
bance, each should be listed separately (e.g., 292.85 alcohol-induced sleep disorder, with