Dr. Joan, NJDA's Director of Dental Benefits, addresses some of the most commonly asked coding questions.
Maxillofacial Prosthetics includes non-orthodontic treatment appliances.
There is no specific code for a sleep apnea device, but because of its similarity to other appliances in the Maxillofacial Prosthetic category, the D5999 ”unspecified maxillofacial prosthesis, by report”
code would be appropriate to submit to dental carriers.
The American Academy of Dental Sleep Medicine (AADSM) suggests appliances are most appropriately billed to a medical plan.
In addition to THE ICD 10 Diagnostic code, one possibility would be the HCPCS Level II
code EO486 oral device/appliance used to reduce upper airway collapsibility, adjustable or non-adjustable, custom fabricated, includes fitting and adjustment.
NJDA offers CE on how to submit ICD 10 Diagnostic coding using the medical claim form …look for upcoming dates for NJDA’s Resource Day.