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We recently delivered an mRNA appliance to a patient diagnosed with sleep apnea. CPT code E0486 was preauthorized and has already been submitted to medical insurance, however our patient questioned if we can also submit to dental insurance after medical EOB is received. Is this possible? Also, I assume when submitting to dental insurance a corresponding CDT code is used?
We have submitted DNA appliances to dental insurance under CDT code D8040 for our non-sleep apnea patients but have never coordinated benefits between medical and dental insurances before.
Any advice is greatly appreciated. Thank you.
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Hi Eastland Dental Center!
Great question! While there are some dental procedures that are medical in nature that both medical and dental may chip in for, oral appliances for a diagnosis of Obstructive Sleep Apnea is not usually one of them!
Because it is a medical diagnosis and a medical treatment using a medical device, all charges should be billed to the medical insurer.
But yes - in a situation where both medical and dental will be billed, you will want to file with medical first, then file to dental second and provide a copy of the primary EOB when you do so.
Hope this helps! Let me know if you have any further questions!
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