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TAP®- Sleep Apnea Insurance

If you are going to file for insurance to cover the costs of the TAP®, file for medical insurance not dental insurance. Usually oral appliances fall under the same category as durable medical equipment and prostheses. If this is not the case, ask if oral appliances are covered by the insurance benefits. Be sure to tell the claims personnel that you have a CPT code. This will speed up the approval process.

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These codes have all had successful prior approval. Be sure to have a note of medical necessity signed by the prescriber and a description of the TAP® and its function below. The codes that we can provide are:

Diagnostic code 327.23 Obstructive Sleep Apnea
E0486 Oral Appliance to Treat Sleep Apnea
70355 Panoramic X-Ray of Jaws
95806 Sleep Study Unattended
99205 New Comprehensive Exam/Evaluation

 

Reevaluation of Established Patient
97703 Six month Orthotic Check
99212 Brief office visit. Evaluation of progress; physician/dentist spends ten minutes face-face-face with the patient and/or family.
99213
Limited office visit. Evaluation of progress; physician/dentist spends 15 minutes face-face with the patient and/or family.
99214 Intermediate office visit. Evaluation of progress; physician/dentist spends 25 minutes face-to-face with the patient and/or family.
99215 Extended office visit. Evaluation of progress; physician/dentist spends 40 minutes face-to-face with the patient and/or family.

Diagnostic Tests and Study Codes
95806
Watch-pat ambulatory sleep study
95828 Overnight home polysomnogram
92512 Nasal Function Study (Rhinometer)
92520 Laryngeal Function Study (Pharyngometer)
70320 Radiological exam, complete full mouth
70330 TMJ transcranial; open/closed four views, bilateral
70350 Baseline cephalogram
70351 Cephalogram with appliance in place
70355 Orthopantogram (panorex)
00471 Diagnostic Study Models

Other important CPT Codes
21110 or
21085 Oral Airway Orthotic, including Temporary
94762 Pulse Oximetry Study