This year, Medicare began funding the use of oral appliance therapy for treatment of obstructive sleep apnea, dependent on approval. Now, the country's most popular oral appliance has been approved for coverage.
In order to be covered, an oral appliance must meet certain characteristics, including:
- Be used for reducing upper airway collapsibility.
- Having a hinged or jointed mechanism
- Be customized
- Be capable of adjustment in increments of one millimeter
- Must retain adjustment
After review, the Pricing, Data Analysis, and Coding (PDAC) Medicare Contractor and each of the four Durable Medicare Equipment Medicare Administrative Contractors have determined that the appropriate billing code for the device is E0486, a covered treatment code. This includes the SomnoDent Classic, the SomnoDent Flex, and the SomnoDent Edentulous.
We are happy that oral appliance therapy has finally been recognized for its successful and comfortable treatment of obstructive sleep apnea.
If you would like to learn more about the coverage and billing of oral appliance therapy, please contact a local sleep dentist today.