We are a dental office that offers oral appliance therapy for sleep apnea. I am trying to determine the correct code to use for visits after the patients receives the oral appliance. 1. What would the correct code/code-range be for the appointment where we deliver the oral appliance, make adjustments if needed to improve fit/comfort, give patients instructions on use, and discuss a follow-up home sleep study in 3-4 months to evaluate appliance efficacy? 2. We see the patient for a series of appointments after the appliance is delivered. Normally, we schedule appointments 2 weeks and 4 weeks after delivery to discuss with the patient how appliance is going, see what changes they are having thus far (e.g. sleeping better, feeling better, etc.), address any problems, adjust protrusive advancement for the first time, answer any questions patient may have. What would the correct code be for these visits? Would I use the appropriate E&M codes (99211-99215) in both instances, or is there a different code that should be used for the post-delivery visits? Another question I have–I understand that there are different E&M codes for new vs. established patients. I was told by a dentist who runs a dental-to-medical billing company that a “new patient” would be considered any patient who we have not seen for sleep apnea before, even if we have seen the patient for other dental services. But, based on coding definitions I find in my cross-coding book and online, it sounds like patients would be considered established if they”ve been seen at our office before, no matter the reason. Can I please get confirmation on this too? THANK YOU!!! I truly appreciate it.
