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New Pediatric Sleep Codes

Posted by admin on Apr 5, 2013 2:00:00 AM

Sleep technologists and sleep center managers - are you aware there are new CPT codes for 2013 for pediatric polysomnography? The Centers for Medicare and Medicaid Services (CMS) has published two new codes (95782 and 95783) for 2013.

    95782 - Polysomnography; younger than 6 years, sleep staging with 4 or more additional parameters of sleep, attended by a technologist

    95783 - Polysomnography; younger than 6 years, sleep staging with 4 or more additional parameters of sleep, with initiation of continuous positive airway pressure therapy or bi-level ventilation, attended by a technologist

These pediatric codes are to be used for patients younger than age 6 undergoing diagnostic testing or initiation of PAP therapy for sleep-disordered breathing attended by a technologist in the sleep center. They recognize the additional monitoring parameters utilized for pediatric polysomnography, including capnography, the lower patient to technologist ratio typical for these young patients, and the greater intensity of work necessary to obtain and evaluate pediatric sleep data. Additionally, these pediatric patients typically are recorded during nine hours of total sleep time during sleep testing.

Diagnostic and PAP studies for pediatric patients age six and older should continue to be billed using the previously existing CPT codes (95810 and 95811). The 2012 AASM Manual for the Scoring of Sleep and Associated Events (V 2.0) outlines the technical requirements for pediatric polysomnography and the appropriate methods for scoring pediatric studies. The manual is available as an online subscription and additionally as a printed manual, and is highly recommended as a primary resource for sleep technologists.