Sorry if this is a repeat question, but I'm new to this site.  I manage a dental office which recently added TAP III appliances to our services.  I have been very excited to finally be able to offer patients an alternative to CPAP and to also identify those who are at risk and exhibiting symptoms of apnea. We refer our patients to a sleep center affiliated with a local hospital and currently have two patients who qualify for an appliance, however, I am stumbling along with the medical insurance end of this. I called 1st insurance company with diagnosis code and CPT code and was told it is not a covered benefit.  However, at the TAP III site, I see their recommended code is 21088 which is not the same code I was told to use.  I have code /E0486.  Question:  have any of you received insurance coverage for your appliance and if so, what codes (diagnosis and procedure code) did you have and which insurance company.  I appreciate any help you may be able to give me as we have at least 10 patients scheduled for sleep study, impressions etc. at this time.

I can't answer you question and maybe patients who have had the device can answer.

But have you contacted the American Academy of Dental Sleep Medicine with your question?  Maybe they can direct you if noone here can:
http://www.aadsm.org/

.... just a thought.


Isn't there a big book on insurance codes?  I just started working in the office of a sleep center, so we handle only 2 or 3 insurance codes because of sleep studies.  And I understand they can change, I've been told.  



Linda


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E0486 sounds like an HCPCS code. I think there is a link to them from mymedicare.com but I'm not sure about from the regular Medicare website. And mymedicare.com is available only to Medicare enrollees.

HCPCS=Healthcare Common Procedure Coding System. It is separate from the ICD-9 and separate from the CPT codes.

HCPCS - Healthcare Common Procedure Coding System
 The Healthcare Common Procedure Coding System (pronounced "hick-picks") was originally created for use under the Medicare program. Today, HCPCS is used by virtually every payer in the United States.


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