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Hi Guest!
Absolutely. Medicare will replace an oral appliance for OSA every 5 years. The language in the LCD states:
"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 of the 5-year RUL."
Hope this helps!
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Could you also tell me what the frequency is for replacements for Medicare?
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Hi Tanner!
Great question. We posed this question to Medicare DME, and they indicated that the lab/manufacturer should provide the dental office with a description and time spent on the repair on the invoice or otherwise. I let the rep know that the large majority of oral device labs/manufacturers do not provide that information, and the rep responded "then they should ask them to start".
:)
Hope this helps, have a great day!
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Can someone please help me with the code K0739 for Medicare. They need a description and time taken for repair. We send our repairs to the lab. What do you put down for time taken?
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