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Medicare coverage for snoring devices can be complex and depends on a variety of factors, such as the specific device used, the medical necessity of the device, and the individual circumstances of the patient. If a patient has OSA and a snoring device is considered medically necessary, a dentist may bill Medicare for the device as DME. The dentist must be enrolled as a Medicare provider and use the appropriate HCPCS code to bill the device. The HCPCS code would be E0486.
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Medicare will not reimburse for a snoring appliance although often the patient will ask you to bill for an appliance that does not meet the requirements of Medicare's Local Coverage Determination (LCD) for Oral Appliance Therapy.
According to Medicare:
Custom fabricated mandibular advancement devices that do not incorporate all of the criteria of the LCD above must be coded as A9720. Do not use HCPCS code E0486.
Tongue positioning appliances are coded A9270.
Oral appliances used to treat snoring without a diagnosis of OSA established with a sleep test as described in the LCD are coded A9270.
For a service or supply that is not expected to be covered, it's important to have an Advance Beneficiary Notice (ABN) on file.
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