How do I get sleep apnea insurance coverage?
When a patient needs a mandibular advancement appliance for sleep apnea, usually dental insurance does not cover it. However, if you send a copy of your sleep study and a prescription from your physician recommending an appliance, most medical insurance will cover the appliance. But it is subject to your deductible.
Medical Billing Codes for Dental Sleep Medicine
ICD-10 Diagnosis Code for Obstructive Sleep Apnea: G47.33
Obstructive Sleep Apnea (Adult) (Pediatric)
CPT Code for Sleep Apnea Custom Oral Appliance: E0486
Oral device/appliance used to reduce upper airway collapsibility, adjustable or nonadjustable, custom fabricated, includes fitting and adjustment.
When using the above E0486 code, most insurers require modifier NU (new equipment). Medicare requires modifier KX showing specific documentation.