How would you bill for a sleep apnea device to be used in conjunction with a CPAP machine to medicare? I have been using a 1500 form using dx: 327.23, 780.57,& 286.09. New office visit 99203 & E0486. With a description of the E0486. Should both of these codes be payable by Medicare and/or commercial insurance payers? Or am I billing this incorrectly?

How would you bill for a sleep apnea device to be used in conjunction with a CPAP machine to medicare? I have been using a 1500 form using dx: 327.23, 780.57,& 286.09. New office visit 99203 & E0486. With a description of the E0486. Should both of these codes be payable by Medicare and/or commercial insurance payers? Or am I billing this incorrectly?

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Asked on March 23, 2011 1:37 pm
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Depending on the device, if you are using TAP appliance you would use 21089 for the appliance and 99002 for the handeling of the appliance. You need to be more specific as to the type of sleep apenea device your are utilizing. Medicare will only pay for an appliance if a sleep study has been performed and a definitive diagnosis has been made, you should look up your LCD's for compatiable ICD-9-CM codes for Medicare. This usually holds true for commercial carriers as well.

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Answered on March 24, 2011 1:37 pm
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