E0486 - Custom Fabricated Oral Appliance for OSA - Coding and Utilization Guidelines

Posted May 27, 2011

Code E0486 describes a custom fabricated oral appliance used for the treatment of obstructive sleep apnea.

E0486 - ORAL DEVICE/APPLIANCE USED TO REDUCE UPPER AIRWAY COLLAPSIBILITY, ADJUSTABLE OR NON-ADJUSTABLE, CUSTOM FABRICATED, INCLUDES FITTING AND ADJUSTMENT

Effective for claims submitted on or after September 01, 2011, the only products that may be billed using code E0486 are those that have undergone Coding Verification Review by the Pricing, Data Analysis, and Coding (PDAC) Contractor and that are listed in the DMECS Product Classification List on the PDAC Web site.

Questions concerning the coding of these products should be referred to the PDAC. For additional information about coverage, refer to the Oral Appliances for the Treatment of Obstructive Sleep Apnea LCD and Policy Article.

            Last Updated Fri, 26 May 2017 12:50:36 +0000