Summary & Overview
CPT 95782: Pediatric Attended Sleep Study with Sleep Staging
CPT code 95782 represents an attended pediatric sleep study for patients under age 6 that documents sleep levels and records at least four additional physiologic sleep parameters. This code captures comprehensive attended polysomnography in young children, a clinically significant service used to evaluate sleep-disordered breathing, parasomnias, and other pediatric sleep concerns. Nationally, accurate coding for pediatric polysomnography supports appropriate clinical management, resource allocation in sleep centers, and alignment with payer coverage policies.
Key payers discussed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical context for pediatric attended studies, common billing considerations, and what typical reimbursement and coverage reviewers evaluate for this service type. The publication outlines benchmarks for utilization where available, summarizes common modifier usage patterns, and highlights policy elements payers often apply to pediatric sleep studies.
This report provides operationally relevant information for billing managers and clinical administrators: how 95782 is defined, typical sites of service, and the administrative factors that influence claim adjudication. Data not available in the input is noted where applicable; the content is intended to assist coding accuracy and payer communications for pediatric sleep laboratory services.
Billing Code Overview
CPT code 95782 describes an attended sleep study for a patient under the age of 6 that includes identification of sleep levels and measurement of at least four additional sleep parameters. This service is a pediatric attended polysomnographic evaluation focused on staging sleep and recording multiple physiologic signals beyond basic monitoring.
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Service type: Pediatric attended sleep study (polysomnography with sleep staging and ≥4 additional parameters)
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Typical site of service: Sleep laboratory or pediatric hospital sleep center, where an attended technologist monitors the study and records the required sleep levels and physiologic parameters.
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Clinical & Coding Specifications
Clinical Context
A 3-year-old child is referred by a pediatrician to a pediatric sleep center for evaluation of suspected sleep-disordered breathing after history of loud snoring, witnessed apneas, daytime behavioral issues, and failure to thrive. The child arrives in the evening for an attended, in-laboratory pediatric polysomnography. A pediatric sleep technologist performs sensor hookup including EEG leads for sleep staging, electrooculography, chin and limb EMG, airflow (nasal pressure and thermistor), respiratory effort bands, pulse oximetry, and end-tidal or transcutaneous CO2 monitoring to ensure at least four additional sleep parameters are recorded. The study is continuously attended by trained staff; technicians document sleep stages, respiratory events, oxygen desaturation indices, arousals, and CO2 trends. A pediatric sleep medicine physician interprets the study and generates a final report specifying sleep architecture, apnea-hypopnea index, oxygen nadir, and any treatment recommendations. Typical sites of service are an accredited pediatric sleep laboratory or hospital-based sleep center equipped for attended pediatric studies and emergency support.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
11 | Professional component | Use when reporting the physician interpretation and report separate from facility technical services. |