Medical Code For Sleep Apnea Appliance

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. E0486 is the current hcpcs medical code for a custom fitted mandibular sleep apnea appliance used for dental sleep medicine medical billing.

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Therefore it is incumbent on the dentist to contact the medical director a provider services representative and or the credentialing contracting supervisor of the insurance company to educate them accordingly.

Medical code for sleep apnea appliance. G47 33 obstructive sleep apnea adult pediatric cpt code for sleep apnea custom oral appliance. The code most often used for a sleep apnea device is e0486 as long as the device meets certain criteria as below. This article provides details on how to make coding sleep apnea appliances easier.

The continuous and simultaneous monitoring and recording of various physiological and pathophysiological parameters of sleep for 6 or more hours with physician review interpretation and report. Networks because of a lack of understanding about the role of oral appliance therapy in the medical treatment of obstructive sleep apnea. Oral appliances for obstructive sleep apnea clinical coverage criteria page 2 of 6 effective 02 01 2020 polysomnography and sleep studies.

Your practice now offers oral sleep apnea appliance therapy to patients and they re asking you to file claims with their medical insurance plans. Icd 10 diagnosis code for obstructive sleep apnea. E0486 oral device appliance used to reduce upper airway collapsibility adjustable or non adjustable custom fabricated includes fitting and adjustment.

D 9941 or l 8048 l 8043 unspecified maxillofacial prosthesis provided by non physician or k 0183 nasal applicator device used with cpap. Sleep medicine codes current procedural terminology cpt codes the cpt code set is a uniform coding system consisting of descriptive terms and identifying codes 5 numeric digits that are used primarily to identify medical services and procedures furnished by physicians and other health care professionals. For those dental practices billing medical insurance here are some recent changes that have taken place and some tips for success.

Icd 780 53 hyper somnia with sleep apnea 786 03 sleep apnea or 780 57 sleep apnea splint procedure codes. The description for e0486 is an oral device appliance used to reduce upper airway collapsibility this includes adjustable or non adjustable custom fabricated fitting and adjustment. On the other hand medical insurance routinely reimburses dentists for oral appliances.

Benefits application this medical policy relates only to the services or supplies described herein. Anyway it is more complex than just a code. Your first reaction might be not us we re dental this is a very understandable reaction.

In order to code this patient correctly we need a diagnosis from a medical point of view and there are many reasons for sleep apnea some threaten the life of the person. Diagnosis and medical management policy bcbsnc will provide coverage for diagnosis and medical management of sleep apnea when it is determined to be medically necessary because the medical criteria and guidelines shown below are met.

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