Sleep Apnea Appliance Medical Code

The code most often used for a sleep apnea device is e0486 as long as the device meets certain criteria as below. Repair cpt code for sleep appliance.

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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.

Sleep apnea appliance medical code. On the other hand medical insurance routinely reimburses dentists for oral appliances. Anyway it is more complex than just a code. When searching through the forum i found 2 possible codes to use for a repair on an oral appliance for sleep apnea.

E0486 is the current hcpcs medical code for a custom fitted mandibular sleep apnea appliance used for dental sleep medicine medical billing. In a dental sleep medicine medical claim the diagnosis diagnosed by a physician as dentists cannot diagnosis obstructive sleep apnea would be obstructive sleep apnea denoted by the icd code g47 33. Icd 780 53 hyper somnia with sleep apnea 786 03 sleep apnea or 780 57 sleep apnea splint procedure codes.

Oral appliance therapy doesn t cover problems like snoring. Custom sleep apnea appliances can only be used to treat specific types of sleep apnea that are diagnosed by a physician. Currently there is only one medical diagnosis code available for osa so if the patient has this condition the diagnosis code on the sleep study will be icd diagnosis code g47 33 which stands for obstructive sleep apnea adult pediatric.

The respiratory disturbance index apnea hypopnea index is an important piece of information that will be needed to process the claim. 1 e0486 or s8262 and use modifier rp which means replacement or repair 2 k0739 repair or nonroutine service for durable medical. 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.

Your practice now offers oral sleep apnea appliance therapy to patients and they re asking you to file claims with their medical insurance plans. The procedure would be oral appliance therapy with a custom. Every medical claim form needs at least one diagnosis code and one procedure code.

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. Your first reaction might be not us we re dental this is a very understandable reaction. D 9941 or l 8048 l 8043 unspecified maxillofacial prosthesis provided by non physician or k 0183 nasal applicator device used with cpap.

For those dental practices billing medical insurance here are some recent changes that have taken place and some tips for success. 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. This article provides details on how to make coding sleep apnea appliances easier.

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