Rank: Guest
Joined: 9/8/2012(UTC)
Posts: 54,136
Was thanked: 16 time(s) in 15 post(s)
|
Hi there,
My pt. wants to do sleep apnea appliance. Could you please tell me what dental procedure code that we could send out for P-D? D8220 is possible? And what medical diagnosis code that we could claim to medical insurance?
Thank you!
Vivian
|
|
|
|
|
|
Rank: Administration
Joined: 11/21/2012(UTC)
Posts: 1,611
Thanks: 37 times
Was thanked: 46 time(s) in 46 post(s)
|
Hi guest!
Custom made oral appliance for Obstructive Sleep Apnea (OSA) are not billed to dental insurance, only to medical. As long as the patient has been diagnosed with OSA through a sleep study, the ICD-10 diagnosis code to use is: G47.33 - Obstructive Sleep Apnea (adult)(pediatric)
The HCPCS (procedure) code to use for the custom made appliance is E0486 - Oral device/appliance used to reduce upper airway collapsibility, adjustable or non-adjustable, custom fabricated, includes fitting and adjustment
Hope this helps!
|
|
|
|
|
|
Rank: Guest
Joined: 9/8/2012(UTC)
Posts: 54,136
Was thanked: 16 time(s) in 15 post(s)
|
Would this also be the code to use for a Rapid Palatal Expander if it was for sleep apnea purposes?
|
|
|
|
|
|
Rank: Administration
Joined: 11/21/2012(UTC)
Posts: 1,611
Thanks: 37 times
Was thanked: 46 time(s) in 46 post(s)
|
Hi Guest!
Great question. I do not typically see palatal expanders alone coded as E0486 (although I do believe there are a few appliances out there that are FDA cleared for snoring & sleep apnea that do include a palatal expander component along with a mandibular advancement component). Many practices we work with submit this service using one of the following:
42299 - Unlisted procedure, palate, uvula
21299 - Unlisted craniofacial and maxillofacial procedure
We have also seen some practices use CPT 21142, which stands for: Reconstruction midface, Le Fort I, segment movement in any direction, without bone graft
- however, adding the modifier -52 which stands for: reduced services, to signify the lack of down-fracturing.
Hope this helps!
|
|
|
|
|
|
Rank: Guest
Joined: 9/8/2012(UTC)
Posts: 54,136
Was thanked: 16 time(s) in 15 post(s)
|
I heard D8090 works for dental appliances through your dental insurance
|
|
|
|
|
|
Rank: Administration
Joined: 11/21/2012(UTC)
Posts: 1,611
Thanks: 37 times
Was thanked: 46 time(s) in 46 post(s)
|
Hi guest!
Yes, D8090 stands for: Comprehensive orthodontic treatment of the adult dentition
D8090 is a dental code, and can certainly be billed to dental insurance to represent orthodontic treatment.
|
|
|
|
|
|
Forum Jump
You cannot post new topics in this forum.
You cannot reply to topics in this forum.
You cannot delete your posts in this forum.
You cannot edit your posts in this forum.
You cannot create polls in this forum.
You cannot vote in polls in this forum.