Sleep Apnea Dental Appliance Cpt Code

August 31, 2021 Post a Comment

Our physician is interested in providing custom oral appliances for the treatment of obstructive sleep apnea. Correct Coding for Oral Appliances for the Treatment of Obstructive Sleep Apnea E0486 Recently questions have arisen about reimbursement for custom fabricated oral appliances coded as E0486 ORAL DEVICEAPPLIANCE USED TO REDUCE UPPER AIRWAY COLLAPSIBILITY ADJUSTABLE OR NON-ADJUSTABLE CUSTOM FABRICATED INCLUDES FITTING AND.

Medical Insurance For Obstructive Sleep Apnea

As long as the patient has been diagnosed with OSA through a sleep study the ICD-10 diagnosis code to use is.

Sleep apnea dental appliance cpt code. The DME MACs received a reconsideration request that prompted an analysis of the language in NCD 24041 and the AB MAC policies LCDs and Billing and Coding articles. Repair CPT Code for Sleep Appliance. Obstructive sleep apnea the diagnosis can only be made by the physician and if prescribed oral appliance therapy is provided by dentists trained in dental sleep medicine and in the use of oral appliances for the management of obstructive sleep apnea.

When searching through the forum I found 2 possible codes to use for a repair on an oral appliance for sleep apnea. The description for E0486 is an oral deviceappliance used to reduce upper airway collapsibility. These oral appliances are sometimes referred to as Mandibular Repositioning Devices MRD.

D5999 unspecified maxillofacial prosthesis by report is the CDT code the ADA recommends to use when billing a snore guard or sleep appliance to a dental plan. CPT codes Code. ResMed12 A custom-fitted appliance is not the same as a custom fabricated appliance.

E0485 and E0486 describe oral appliances which are used for the treatment of Obstructive Sleep Apnea OSA. After that analysis we determined that the home sleep test information in the Oral Appliances for Obstructive Sleep Apnea L33611 was duplicative. Custom Oral Appliances for Obstructive Sleep Apnea Policy Number.

Some insurers accept the G codes while others accept the CPT codes for HSATs 95800 95801 and 95806. 1 E0486 or S8262 and use modifier RP which means replacement or repair 2 K0739 - REPAIR OR NONROUTINE SERVICE FOR DURABLE MEDICAL. Correct Coding for Oral Appliances for the Treatment of Obstructive Sleep Apnea E0486.

CPT Code for Sleep Apnea Custom Oral Appliance. E0486 Oral deviceappliance used to reduce upper airway collapsibility adjustable or non-adjustable custom fabricated includes fitting and adjustment. Dental sleep medicine specialty focuses on the management of sleep-related breathing disorders including snoring and obstructive sleep apnea through the use of oral appliance therapy.

The G codes G0398 G0399 and G0400 which describe home sleep apnea testing HSAT services were added to the Healthcare Common Procedure Coding System HCPCS Level II in 2008. E0486 is the current HCPCS medical code for a custom-fitted mandibular sleep apnea appliance used for dental sleep medicine medical billing. Custom made oral appliance for Obstructive Sleep Apnea OSA are not billed to dental insurance only to medical.

G4733 - Obstructive Sleep Apnea adultpediatric. D-9941 or L-8048L-8043 Unspecified Maxillofacial Prosthesis provided by non-physician. Paramount applies coding edits to all medical claims through coding logic software to evaluate the accuracy and adherence to accepted national standards.

Oral appliance therapy A sleep appliance is billed as E0486 Oral DeviceAppliance Used to Reduce Upper Airway Collapsibility Adjustable or Non-Adjustable Custom Fabricated Includes Fitting and Adjustment. The code most often used for a sleep apnea device is E0486 as long as the device meets certain criteria as below. Polysomnography and Home Sleep Testing CPT and HCPCS Codes The following codes may not be all inclusive.

Most insurers will reimburse for repairs unless neglect is a factor and some also reimburse for a lost missing or stolen appliance. 01102017 GUIDELINES This policy does not certify benefits or authorization of benefits which is designated by each individual policyholder contract. CPT codes Code Description 95805 Multiple sleep latency or maintenance of wakefulness testing recording analysis and interpretation of physiological measurements of sleep during multiple trials to assess sleepiness Table 5.

Medical HCPCS code for dental practice to use when billing medical insurance for custom made oral appliances for Obstructive Sleep Apnea OSA and snoring There are two codes to choose from when coding for oral appliances being used to treat snoring and Obstructive Sleep Apnea. Dental practices provide oral appliance therapy OAT in partnership with physicians and they can rely on experienced medical billing companies to support their claim submission tasks. When using the above E0486 code most insurers require modifier NU new equipment.

I have found the following codes related to this service. This includes adjustable or non-adjustable custom fabricated fitting and adjustment. Please keep in mind that the dental carrier is highly unlikely to pay for these types of appliances.

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