Hi h teller!
Great question,
Depending on the nature of the repair, here are a few codes to choose from for repair of a custom made oral appliance for OSA:
-K0739 - REPAIR OR NONROUTINE SERVICE FOR DURABLE MEDICAL EQUIPMENT OTHER THAN OXYGEN REQUIRING THE SKILL OF A TECHNICIAN, LABOR COMPONENT, PER 15 MINUTES
-L4205 - Repair of orthotic device, labor component, per 15 minutes
-L4210 - Repair of orthotic device, repair or replace minor parts
Here is a link to a bulletin release by CMS relating to the reimbursement rates for K0739 and L4250 (on page 4):
http://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNMattersArticles/downloads/MM8133.pdf The Medicare article to the LCD for oral appliances states "Repairs are covered for items that meet the coverage criteria. To repair means to fix or mend and to put the item back in good condition after damage or wear. Repairs are covered when necessary to make the item serviceable. If the expense for repairs exceeds the estimated expense of purchasing another item, no payment can be made for the excess."
Here is a link to the Article relating to coding guides for OAT for OSA:
https://www.noridianmedicare.com/dme/coverage/docs/lcds/current_articles/oral_appliances.htmlAnd a link to the LCD (medical policy) with coverage criteria for Medicare patients:
https://www.noridianmedicare.com/dme/coverage/docs/lcds/current_lcds/oral_appliances.htm(Note: The above links are for Medicare DME jurisdiction D. You can view all other jurisdictions at
www.cms.gov)
Hope this helps! Please feel free to contact us with any further questions.