DentalWriter Forum

Your central resource for DentalWriter posts, blogs, training resources, faq's, and more.

Notification

Icon
Error

Post a reply
From:
Message:

Maximum number of characters in each post is: 32767
Bold Italic Underline   Highlight Quote Choose Language for Syntax Highlighting Insert Image Create Link   Unordered List Ordered List   Left Justify Center Justify Right Justify   More BBCode Tags Check Spelling
Font Color: Font Size:
Security Image:
Enter The Letters From The Security Image:
  Preview Post Cancel

Last 10 Posts (In reverse order)
courtneydsnow Posted: Thursday, August 17, 2017 10:55:35 AM(UTC)
 
Hi abauer!

Yes, Medicare's LCD for oral appliances for OSA specifies a 5 year replacement period. Here is the language from the LCD below:

"Oral appliances are eligible for replacement at the end of their 5-year reasonable useful lifetime (RUL). These items may be replaced prior to the end of the 5-year RUL in cases of loss, theft, or irreparable damage. Irreparable damage refers to a specific accident or to a natural disaster (e.g., fire, flood). Replacement due to wear-and-tear as the result of everyday use will be denied as statutorily non-covered prior to the expiration ofthe 5-year RUL."

Here is a link to the LCD: https://med.noridianmedicare.com/documents/2230703/7218263/Oral+Appliances+for+Obstructive+Sleep+Apnea+LCD+and+PA/dc994aa8-c706-438b-9e31-db18a6be1358

Other insurers generally do also specify their replacement period in their medical policies. Many have followed suit with Medicare at 5 years (i.e. Aetna). I have seen a few over the years that state 3 years instead.

Hope this helps!
abauer Posted: Wednesday, August 16, 2017 3:03:10 PM(UTC)
 
Does Medicare specifically state somewhere a frequency for coverage of an oral appliance?
What about other medical companies?
Thanks for any input!