Dear Medical Colleague,
Patients with a diagnosis of mild or moderate OSA are often excellent candidates for oral appliance therapy. The AASM has recommended this as a first treatment option for these patients since 2006.
As you well know, there is a large number of people who should be using a PAP device but are simply unable or unwilling to do so. Since these patients have “fallen off the wagon”, they remain at risk of serious co-morbid issues like a CVA or MI. Many of them would be willing and able to use an oral appliance if it was offered to them as an option. Even if this approach did not result in a return to a normal AHI, any significant reduction would certainly lower their overall co-morbid health risks.
Of course, PAP therapy remains the Gold Standard for patients in the severe category, and every attempt should be made to get them and keep them on PAP therapy. However, for patients who simply can’t or won’t, an oral appliance may be of significant help.
Please have your staff gather the information listed below from your records, including a signed prescription for the device. We must have the information below before we can see the patient for an exam. We want this life-saving treatment to be as affordable as possible for your patients, so we are ‘in network’ with many plans and will handle billing and insurance for your patients. Most dentists are not Participating Providers in medical insurance plans.
Once the patient’s oral appliance is properly advanced, we will refer them back to the Sleep MD for a sleep study to confirm the subjective improvements we see.
Thank you again for the opportunity to participate in this life-saving therapy. If I can ever assist you or answer any questions about this approach, please don’t hesitate to call or email me. I look forward to working in partnership with you for the benefit or our mutual patients.
Should you ever have any questions, feel free to call the office, or if we are closed, reach out to me on office at (253) 236-5240. You can also contact our office online and we will get back to you as soon as possible.
When you are ready to refer a patient for evaluation, simply write a prescription for an oral appliance, code E0486, and indicate a diagnosis of Obstructive Sleep Apnea, G47.33.
Include copies of chart notes pre and post sleep study (required for Medicare) and fax everything to (866) 861-6286. The prescription must be signed by the referring physician and a copy of the diagnostic (not spit night) sleep study included, in order for us to obtain a pre-determination of benefits for your patient.