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Oral Appliance for Sleep Apnea


Our physician is interested in providing custom oral appliances for the treatment of obstructive sleep apnea. I have found the following codes related to this service.


Procedure Codes: D-9941 or L-8048/L-8043 (Unspecified Maxillofacial

Prosthesis provided by non-physician.)

Or K-0183 (Nasal applicator device used with CPAP.

CPT 21085- Complete Oral Appliance Therapy

CPT 21110- Used for all Oral Appliances, patient is responsible for

obtaining authorization prior to payment or receiving appliance.


AND


HCPC INSURANCE CODE:

21089 or 5999 Unlisted Maxillofacial Prosthetic Procedure

S8260 Oral Orthotic for treatment of sleep apnea,

Includes fitting, fabrication, and materials

S8262 Mandibular orthopedic repositioning device

E0485 Oral device/appliance used to reduce upper airway collapsibility, adjustable

or non-adjustable, prefabricated, includes fitting and adjustment

E0486 Oral device/appliance used to reduce upper airway collapsibility, adjustable

or non-adjustable, custom fabricated, includes fitting and adjustment


Have any of you used these codes successfully? Do the insurance carriers reimburse ENT for the DME related to this service? Any obstacles you are encountering on a regular basis?