US Medicare Coverage Decision: SomnoDent Assigned Medicare Code

SomnoMed provides diagnostic and treatment solutions for Sleep Breathing Disorders such as Obstructive Sleep Apnea and manufactures the SomnoDent product range. SomnoMed announces that the Pricing, Data Analysis, and Coding (PDAC) Medicare Contractor and each of the four Durable Medicare Equipment (DME) Medicare Administrative Contractors (MACs) have determined that the appropriate Medicare Healthcare Common Procedural Coding System (HCPCS) code to use when billing for the SomnoDent product range is E0486.

SomnoMed, Inc., manufacturer of the world’s leading oral appliance, SomnoDent for the treatment of Obstructive Sleep Apnea announces that the PDAC Medicare Contractor and each of the four DME MACs have determined that the appropriate HCPCS code to use when billing for the SomnoDent Classic, SomnoDent Flex, and SomnoDent Edentulous is E0486.

According to each of the four DME MAC jurisdictions, in order to be designated code E0486, the oral appliance must be used to reduce upper airway collapsibility, be adjustable, and custom fabricated. A custom-fabricated oral appliance is defined as one that is individually made for a specific patient.

“SomnoMed appreciates the timely decision made by PDAC and the DME MACs and especially those Centers for Medicare & Medicaid Services (CMS) clinicians involved in reviewing SomnoMed’s evidence based application”, said Ralf Barschow, CEO. “SomnoMed would also like to recognize the American Academy of Dental Sleep Medicine (AADSM) and American Academy of Sleep Medicine (AASM) for continuing to develop new standards of practice as well as the American Sleep Apnea Association (ASAA) for their continued dedication to inform and enhance the well-being of those affected by this chronic disease.”

Obstructive Sleep Apnea affects tens of millions of Americans and is associated with obesity, diabetes, high blood pressure, increased risk of heart attack, stroke, memory/performance problems, depression and higher accident rates (J Clin Sleep Med 2009:5(3):263-276). SomnoDent is a medical device used to treat Obstructive Sleep Apnea. Considered a sleeping disorder, this medical condition must be treated with a medical device.

While there are an increasing number of generic oral appliances available, only SomnoDent is independently clinically validated, has a three year warranty and incorporates proprietary materials and design features to maximize patient comfort. SomnoMed firmly believes that dental sleep medicine clinicians will continue to embrace patient-focused and evidence-based medical devices.

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Source: Frisco, TX (PRWEB)

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