How To Use CPT Code 95782

CPT 95782 describes the process of conducting an attended sleep study for patients under the age of 6, with the identification of sleep levels and at least four additional sleep parameters. 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 95782?

CPT 95782 can be used to describe the diagnostic sleep test service called polysomnography, which is used to assess sleep disorders in patients under the age of 6. This code specifically refers to an attended sleep study, where a technologist is present with the patient during the recording. The test involves the identification of sleep levels using electroencephalography (EEG), electromyography (EMG), and electrooculography (EOG), along with at least four additional sleep parameters.

2. Official Description

The official description of CPT code 95782 is: ‘Polysomnography; younger than 6 years, sleep staging with 4 or more additional parameters of sleep, attended by a technologist.’

3. Procedure

1. A technologist is present with the patient during the attended sleep study.
2. The sleep study involves the identification of sleep levels using EEG, EMG, and EOG.
3. At least four additional sleep parameters are recorded, such as ECG, airflow, respiratory effort, oxyhemoglobin saturation, capnography, or bilateral anterior tibialis EMG.
4. The recording must be conducted for a minimum of seven hours, with reduced services modifier 52 appended if the recording is less than six hours.

4. Qualifying circumstances

CPT 95782 is used for patients under the age of 6 who require a diagnostic sleep test to assess sleep disorders. The test must involve sleep staging with at least four additional parameters. The presence of a technologist during the recording is also a qualifying circumstance for this code.

5. When to use CPT code 95782

CPT code 95782 should be used when conducting an attended sleep study for patients under the age of 6, with sleep staging and at least four additional sleep parameters. This code is appropriate for assessing sleep disorders in this specific age group.

6. Documentation requirements

To support a claim for CPT 95782, the following documentation is required:

• Confirmation of the patient’s age and the need for a sleep study
• Details of the sleep staging process using EEG, EMG, and EOG
• Documentation of at least four additional sleep parameters recorded
• Duration of the recording, with reduced services modifier 52 if applicable
• Signature of the technologist who conducted the attended sleep study

7. Billing guidelines

When billing for CPT 95782, ensure that the sleep study is conducted for patients under the age of 6 and includes sleep staging with at least four additional sleep parameters. If continuous positive airway pressure therapy or bi-level ventilation is also initiated during the same session, CPT code 95783 should be reported. Use professional component modifier 26 if reporting only the professional component, and use technical component modifier TC if reporting only the technical component. Do not append modifiers if reporting a global service where one provider renders both components.

8. Historical information

CPT 95782 was added to the Current Procedural Terminology system on January 1, 2013. There have been no updates to the code since its addition.

9. Examples

1. A technologist conducts an attended sleep study for a 4-year-old patient, recording sleep levels using EEG, EMG, and EOG, along with additional parameters such as ECG and respiratory effort.
2. An attended sleep study is performed for a 5-year-old patient, with sleep staging and the recording of additional parameters including oxyhemoglobin saturation and bilateral anterior tibialis EMG.
3. A 3-year-old patient undergoes an attended sleep study, with sleep levels identified using EEG, EMG, and EOG, along with the recording of additional parameters such as airflow and capnography.
4. A technologist conducts an attended sleep study for a 2-year-old patient, recording sleep stages using EEG, EMG, and EOG, along with additional parameters including ECG and respiratory effort.
5. An attended sleep study is performed for a 6-month-old patient, with sleep staging and the recording of additional parameters such as oxyhemoglobin saturation and bilateral anterior tibialis EMG.
6. A 1-year-old patient undergoes an attended sleep study, with sleep levels identified using EEG, EMG, and EOG, along with the recording of additional parameters such as airflow and capnography.
7. A technologist conducts an attended sleep study for a 3-year-old patient, recording sleep stages using EEG, EMG, and EOG, along with additional parameters including ECG and respiratory effort.
8. An attended sleep study is performed for a 4-year-old patient, with sleep staging and the recording of additional parameters such as oxyhemoglobin saturation and bilateral anterior tibialis EMG.
9. A 2-year-old patient undergoes an attended sleep study, with sleep levels identified using EEG, EMG, and EOG, along with the recording of additional parameters such as airflow and capnography.
10. A technologist conducts an attended sleep study for a 6-month-old patient, recording sleep stages using EEG, EMG, and EOG, along with additional parameters including ECG and respiratory effort.