How To Use CPT Code 94777

CPT 94777 describes the review, interpretation, and preparation of a report for pediatric home apnea monitoring event recording. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, similar codes and billing examples.

1. What is CPT Code 94777?

CPT 94777 can be used to report the review, interpretation, and preparation of a report for pediatric home apnea monitoring event recording. This code is specifically for the professional component of the service, which involves analyzing the data collected during a 30-day period of monitoring and preparing a report based on the findings.

2. Official Description

The official description of CPT code 94777 is: ‘Pediatric home apnea monitoring event recording including respiratory rate, pattern and heart rate per 30-day period of time; review, interpretation and preparation of report only by a physician or other qualified health care professional.’

3. Procedure

1. A physician or other qualified healthcare professional orders a pediatric home apnea monitor for a patient.
2. The provider attaches stick-on patches or a belt to the infant’s chest or stomach to detect respiratory rate and heart rate.
3. The monitor is used for a 30-day period of time to record and collect data on respiratory rate, pattern, and heart rate during unattended periods and sleep.
4. The recorded data is downloaded and reviewed by the physician or other qualified healthcare professional.
5. The provider identifies and quantifies any abnormal respiratory rate or heart rate patterns.
6. A written report is prepared summarizing the significance of the abnormalities and providing recommendations for continuation or discontinuation of the monitoring.

4. Qualifying circumstances

CPT 94777 is used when a physician or other qualified healthcare professional reviews, interprets, and prepares a report for pediatric home apnea monitoring event recording. This service is typically provided for infants at risk for recurrent apnea, bradycardia, and hypoxemia after hospital discharge. The provider must be qualified to independently report professional services and must have the necessary education, training, licensure/regulation, and facility privileging (when applicable).

5. When to use CPT code 94777

CPT code 94777 should be used when a physician or other qualified healthcare professional performs the review, interpretation, and preparation of a report for pediatric home apnea monitoring event recording. This code is specifically for the professional component of the service and should not be reported if the provider also performed monitor attachment, monitoring, data download, or other related services.

6. Documentation requirements

To support a claim for CPT 94777, the physician or other qualified healthcare professional must document the following information:

• Order for pediatric home apnea monitoring
• Details of the monitoring period (30 days)
• Recorded data and findings
• Abnormal respiratory rate or heart rate patterns
• Summary of the significance of abnormalities
• Recommendations for continuation or discontinuation of monitoring

7. Billing guidelines

When billing for CPT 94777, ensure that the service is performed by a physician or other qualified healthcare professional and that it involves only the review, interpretation, and preparation of a report for pediatric home apnea monitoring event recording. Do not report this code with electrocardiographic monitoring codes. If the provider also performed monitor attachment, monitoring, data download, or other related services, a different code should be used.

8. Historical information

CPT 94777 was added to the Current Procedural Terminology system on January 1, 2007. There have been no updates to the code since its addition.

9. Examples

1. An infant born prematurely with residual lung disease of prematurity and occasional episodes of self-stimulated apnea is sent home with a pediatric home apnea monitor. The physician reviews the recorded data, identifies abnormal respiratory rate patterns, and prepares a report with recommendations for continuation or discontinuation of the monitoring.
2. A pediatrician orders a home apnea monitor for an infant with a history of bradycardia. After the 30-day monitoring period, the physician reviews the data, quantifies abnormal heart rate patterns, and prepares a report summarizing the significance of the abnormalities.
3. A neonatologist prescribes a home apnea monitor for an infant with a grade II intraventricular hemorrhage. The physician reviews the recorded data, identifies abnormal respiratory rate and heart rate patterns, and prepares a report with recommendations for the continuation or discontinuation of the monitoring.
4. A pediatric pulmonologist orders a home apnea monitor for an infant with hypoxemia. After the monitoring period, the physician reviews the data, quantifies abnormal respiratory rate and heart rate patterns, and prepares a report summarizing the significance of the abnormalities.
5. A pediatric cardiologist prescribes a home apnea monitor for an infant with a history of recurrent apnea. The physician reviews the recorded data, identifies abnormal heart rate patterns, and prepares a report with recommendations for the continuation or discontinuation of the monitoring.
6. A pediatric neurologist orders a home apnea monitor for an infant with a neurological condition. After the 30-day monitoring period, the physician reviews the data, quantifies abnormal respiratory rate and heart rate patterns, and prepares a report summarizing the significance of the abnormalities.