OAT for Medicare Patients

American Academy of Dental Sleep Medicine
Tuesday, October 9, 2012

The following information is of importance to AADSM members who are enrolled with Medicare as a durable medical equipment (DME) supplier and treat Medicare patients using custom fabricated oral appliances for obstructive sleep apnea.

In July 2012, a new policy article for oral appliance therapy (OAT) was published by the Durable Medical Equipment Medicare Administrative Contractors (DME MACs).  The article outlines revised coding guidelines for OAT devices used to treat Medicare patients. 

Based on these revised guidelines, the Medicare Pricing, Data Analysis and Coding (PDAC) contractor has re-reviewed devices that previously received PDAC approval.  New details from these device re-reviews began to appear on the PDAC website in September 2012.

To help clarify the new details on the website's device list, the AADSM has reached out to PDAC staff for more information, which is available on the PDAC-Approved Devices page on the AADSM website.

The AADSM will continue to provide members with additional information about Medicare coding guidelines on the AADSM website and in the e-news member update.


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