And hcpc insurance code. Anyway it is more complex than just a code.
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The code most often used for a sleep apnea device is e0486 as long as the device meets certain criteria as below.
Oral appliance for sleep apnea cpt code. To this end the dental professional may consider sharing the aadsm protocols and aasm practice parameters with the insurance company to emphasize that oral appliance therapy is an accepted treatment for this medical condition. In order to support and substantiate claims for an oral sleep apnea device appliance e0486 the following documentation must be kept on file and supplied by the dentist dmd dds for review upon request. Cpt 21085 complete oral appliance therapy cpt 21110 used for all oral appliances patient is responsible for obtaining authorization prior.
E0486 oral device appliance used to reduce upper airway collapsibility adjustable or non adjustable custom fabricated includes fitting and adjustment. There are no specific dental codes available for oral appliances for obstructive sleep apnea osa and it s almost unheard of for dental plans to reimburse for these devices. A copy of the original physician s md do etc request order or referral to dentist dmd dds for the oral sleep apnea appliance.
786 03 sleep apnea or 780 57 sleep apnea splint procedure codes. 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 device appliance used to reduce upper airway collapsibility adjustable or non adjustable custom fabricated includes fitting and adjustment. Cpt 21110 used for all oral appliances patient is responsible for obtaining authorization prior to payment or receiving appliance.
Some insurers accept the g codes while others accept the cpt codes for hsats 95800 95801 and 95806. On the other hand medical insurance routinely reimburses dentists for oral appliances. There are two codes to choose from when coding for oral appliances being used to treat snoring and obstructive sleep apnea osa e0486 and e0485.
Correct coding for oral appliances for the treatment of obstructive sleep apnea e0486. 21089 or 5999 unlisted maxillofacial prosthetic procedure s8260 oral orthotic for treatment of sleep apnea includes fitting fabrication and materials s8262 mandibular orthopedic. For those dental practices billing medical insurance here are some recent changes that have taken place and some tips for success.
D 9941 or l 8048 l 8043 unspecified maxillofacial prosthesis provided by non physician or k 0183 nasal applicator device used with cpap. E0486 is commonly covered by medical insurance for patients who meet criteria. Oral appliance therapy in the medical treatment of obstructive sleep apnea.
G codes home sleep apnea testing 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. E0485 is commonly n. Icd 10 diagnosis code for obstructive sleep apnea.
G47 33 obstructive sleep apnea adult pediatric cpt code for sleep apnea custom oral appliance.
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