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  • Polysomnogram/sleep Study Order Form Children's Healthcare Of ... - Choa

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2-Hole 1/4 2 3/4 c-to-c DT18123 Legal Name: Children's Healthcare of Atlanta The Children's Sleep Center Polysomnogram/Sleep Study Order Form Please print clearly DOB: SEX: Female Male 3-Hole 1/4.

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How long does the test take? Your child will stay in the sleep lab overnight. For some tests, your child will also stay part of the next day.

Small plastic prongs at the nose will measure your child's exhaled air. Elastic or cloth belts will be placed on your child's chest and stomach, usually over her pajamas. Stick-on electrodes will be placed on your child's face and chest to measure eye movements, heart rate and muscle tone during sleep.

Reporting 95800 includes a measurement of sleep time and 95806 describes a measurement of respiratory airflow and effort. For accurate coding, 95800, 95801, and 95806 must include 6 hours of recording time.

The most widely used type of sleep study is a polysomnogram. While you slumber in a high-tech sleep lab that looks like a comfortable hotel room, a technician in a nearby room records your brain activity and selected information from your body.

Make sure your child has clean, dry hair. Help your child feel comfortable by letting them pick out their favorite pajamas, bedtime stories, pillow, blanket or other items that help during bedtime at home. Make sure your child had supper before coming to the Sleep Lab. Bring any medicines your child needs.

Here's what's required to process your order: (1) Completed demographics and insurance information. Most insurance plans cover sleep studies. ... (2) Clear reasons for testing (including progress notes) ... (3) Select the proper study. ... (4) Send your order to the sleep center. ... Use this form to order a sleep study:

Sleep studies are often ordered to find out if a child has problems breathing while asleep. Obstructive sleep apnea (OSA) is one of the most common reasons for doing a sleep study. It is often found in children who snore, gasp for air, or stop breathing while asleep. Children with enlarged tonsils may also have apnea.

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
Content Takedown Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
Industries
Forms in Spanish
Localized Forms
State-specific Forms
Forms Kit
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
+1 833 426 79 33
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232