Codes used in billing oral appliance therapy

PROVarious insurance companies have “in-house” codes that they use for oral orthotic therapy for obstructive sleep apnea other use commonly accepted codes. Here are the codes in use in 2005.

Most common is S8260: “An oral orthotic for the treatment of obstructive sleep apnea”.

99002: ‘Miscellaneous’ used for boil and bite appliances, requires explanation

99002.22 Advanced oral appliance design and fabrication. Explanation required.

E1399: Medicare , miscellaneous code. Medicare will not ‘prior authorize’ treatment.

21089: Unlisted maxillofacial prosthetic procedure (used by BCBS IL and some CIGNA policies)

21085: Unlisted maxillofacial procedure. Used by Tricare

42999: Maintenance of airway, Unspecified. (Requires explanation)

Denist1

Dentists play an important role in the team approach to the treatment of obstructive sleep apnea.

Physicians, dentists, psychologists, and respiratory therapists all pool their knowledge to treat each patient appropriately and effectively.

Dentists who are specifically trained in aspects of sleep medicine and have a command of multiple appliance modalities are of great help to physicians in treating patients with sleep disordered breathing problems.

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The National Center on Sleep Disorders Research, can provide you with sleep education materials. As well as publications on heart, lung and blood research:
Two Rockledge Center, Suite 7024, 6701Rockledge Drive, MSC 7920, Betesda, MD 20892-7920
(P)301.435.0199 /
(F) 301.480.3451
www.nhlbi.nih.gov/about/ncsdr/

Information about sleep disorders may be obtained from NHLBI:
NHLBI Information Center
P. O. Box 30105, Bethesda, MD 20824-0105
(P) 301.251.1222 / (F) 301.251.122
www.nhlbi.nih.gov/