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Dr. Scriabin,
Medicare considers an appliance medically necessary when the patient has an AHI equal or greater than 5 with comobidities.
Also, as of November 1, 2012, Medicare will reimburse for Herbst appliances from Dynaflex lab, Space Maintainers lab or Gergen dental lab.
If you need to link to the approved appliances, let me know.
Best regards,
Rose Nierman
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We have a patient who has an AHI of 1.6. She was diagnosed with sever snoring without OSA. She also has emphysema and COPD. She has had a CPAP for 3 years. She is on Medicare. Is there any way to bill Medicare to get coverage for her?
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