How To Use CPT Code 94772

CPT 94772 describes the process of circadian respiratory pattern recording for infants. This article will cover the official description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, similar codes and billing examples.

1. What is CPT Code 94772?

CPT 94772 is used to record the circadian respiratory pattern of infants. It involves the use of a special machine to measure the infant’s breathing, heart rate, and oxygen levels during sleep over a period of 12 to 24 hours.

2. Official Description

The official description of CPT code 94772 is: ‘Circadian respiratory pattern recording (pediatric pneumogram), 12-24 hour continuous recording, infant.’

3. Procedure

1. The testing provider sets up the pneumogram equipment and attaches sensors to the infant.
2. The sensors detect information such as the infant’s heart rate, oxygen level, effort required to breathe, and flow of air into the lungs as the infant sleeps.
3. The recording may last between 12 and 24 hours, capturing the circadian respiratory pattern of the infant.
4. The interpreting provider reviews the data and interprets it, identifying any abnormal breathing patterns, such as apnea (a pause in breathing) and related slow heart rhythm.
5. The interpreting provider records the interpretation in the medical record.

4. Qualifying circumstances

CPT 94772 is used for infants who require circadian respiratory pattern recording. This test is particularly ordered for preterm infants in the process of weaning from home apnea monitors. The test must be performed on infants, and separate procedure codes for electromyograms, EEG, ECG, and recordings of respiration are excluded when reporting CPT 94772.

5. When to use CPT code 94772

CPT code 94772 should be used when recording the circadian respiratory pattern of infants. It is not appropriate to use this code for any other age group or for recording other physiological parameters.

6. Documentation requirements

To support a claim for CPT 94772, the following documentation is required:

• Infant’s medical record with the indication for the test
• Details of the equipment used and the duration of the recording
• Interpretation of the data by the interpreting provider

7. Billing guidelines

When billing for CPT 94772, append modifier 26 if reporting only the professional component of the service. Append modifier TC if reporting only the technical component, unless the hospital provided the technical component. Do not append a professional or technical modifier when reporting a global service in which one provider renders both components. It is important to follow the specific guidelines of the payer when submitting claims for CPT 94772.

8. Historical information

CPT 94772 was added to the Current Procedural Terminology system on January 1, 1992. The code underwent a change on January 1, 2007, with an updated description of the procedure.

9. Examples

1. An infant undergoing a 24-hour circadian respiratory pattern recording to monitor their breathing and heart rate during sleep.
2. A preterm infant being weaned from a home apnea monitor, requiring a 12-hour circadian respiratory pattern recording to assess their respiratory patterns.
3. An interpreting provider reviewing the data from a 24-hour circadian respiratory pattern recording and identifying abnormal breathing patterns in an infant.
4. A testing provider setting up the pneumogram equipment and attaching sensors to an infant for a 12-hour circadian respiratory pattern recording.
5. An infant’s medical record documenting the indication for a 24-hour circadian respiratory pattern recording and the interpretation of the data by the interpreting provider.