Nierman Practice Management (Home) › Forums › Dental to Medical Billing, Coding & Documentation › Billing Repairs for OSA to Medicare › Unique Title 1318 1318 1318
Hi Guest! Absolutely. Medicare will replace an oral appliance for OSA every 5 years. The language in the LCD states: “Oral appliances are eligible for replacement at the end of their 5-year reasonable useful lifetime (RUL). These items may be replaced prior to the end of the 5-year RUL in cases of loss, theft, or irreparable damage. Irreparable damage refers to a specific accident or to a natural disaster (e.g., fire, flood). Replacement due to wear-and-tear as the result of everyday use will be denied as statutorily non-covered prior to the expiration of the 5-year RUL.” Hope this helps!