Medicare PDAC Verifies More Devices

American Academy of Dental Sleep Medicine
Monday, January 7, 2013

In July 2012, revised coding guidelines were published for oral appliance therapy (OAT) devices used to treat Medicare patients with obstructive sleep apnea (OSA). A custom fabricated oral appliance for OSA is eligible for Medicare reimbursement only if the Medicare Pricing, Data Analysis and Coding (PDAC) contractor has listed or reverified it as code E0486 according to the revised guidelines. 

In the past month, several devices have received coding verification from PDAC. As of Jan. 4, 2013, these are currently the only devices that are eligible for Medicare reimbursement:

  • Herbst by Dynaflex
  • Herbst by Gergen's Orthodontic Lab
  • TAP by Airway Management
  • TAP 3 Elite by Airway Management
  • Telescopic Herbst by Great Lakes Orthodontics
  • SUAD by Strong Dental LTD
  • SUAD Elite by Strong Dental LTD
  • UCLA Modified Herbst by Space Maintainers Laboratory
Additional details about devices listed by PDAC are available to members on the AADSM website.


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