Correct Coding - ApniCure Winx Sleep Therapy System

Joint DME MAC Publication

The ApniCure, Inc. Winx® Sleep Therapy System uses continuous low suction delivered to the oral cavity via a fitted mouthpiece to move the soft tissue and increase the size of the airway in the retropharynx and oral cavity. ApniCure claims that this increased airway size is an effective treatment for Obstructive Sleep Apnea (OSA) (ICD-9 327.23).

The product consists of a system console, connecting tubing and an oral interface (mouthpiece).  Product coding was assigned in the January 2014 HCPCS code update.

  • Console - E0600 (RESPIRATORY SUCTION PUMP, HOME MODEL, PORTABLE OR STATIONARY, ELECTRIC)
  • Tubing - A7002 (TUBING, USED WITH SUCTION PUMP, EACH)
  • Oral interface - A7047 (ORAL INTERFACE USED WITH RESPIRATORY SUCTION PUMP, EACH)

Payment rules for E0600 and A7002 are addressed in the Local Coverage Determination (LCD) for Suction Pumps. HCPCS code A7047 will be added to that LCD.  The current LCD does not provide reimbursement for E0600 when used to treat OSA.

A7047 was created to describe the oral interface used as part of the Winx or similar systems.  This code is not to be used for oral appliances used to treat OSA or for any other type of oral suction appliances.  Do not use the oral appliance HCPCS codes E0485 or E0486 for this interface.

Refer to the Suction Pumps LCD and related Policy Article for additional information about E0600, A7002 and A7047.

Refer to the Oral Appliances Used for the Treatment of Obstructive Sleep Apnea LCD and related Policy Article for additional information about E0485 and E0486.

For questions about correct coding, contact the PDAC Contact Center at (877) 735-1326 during the hours of 8:30 a.m. to 4:00 p.m. CT, Monday through Friday, or e-mail the PDAC by completing the DME PDAC Contact Form located on the PDAC website https://www.dmepdac.com/.

 

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