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Last 10 Posts (In reverse order)
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courtneydsnow Posted: Tuesday, January 15, 2013 10:09:35 AM(UTC)
 
Hi dentlc01!

The two modifiers that Medicare requires for E0486 are:

NU - to indicate the oral appliance is new durable medical equipment
KX - to indicate the patient meets all Medicare qualifying criteria for E0486 (i.e. diagnosed with OSA AHI 5+, if severe has tried and failed CPAP, etc)

Hope this helps!
dentlc01 Posted: Monday, January 14, 2013 12:44:02 PM(UTC)
 
I have submitted a claim to United Health Care for an Oral Sleep Appliance. We've spplied codes 327.23 (diagnosis) and E0486 (service). The insurance company is requiring, what they've told me is, a modifier code. They have stated that they follow the Medicare guidlines and that a modifier code is required in this scenerio.

Any suggestions as to what code I should submit?

Thanks

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