Rank: New Member
Joined: 12/2/2016(UTC)
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Can we bill out the E0486 code before the patient has the appliance seated?
For example can we do one large superbill with all the office visits, the E0486 and xrays all at the begging of treatment? Or do we need to break it up into an initial visit and then a seat visit?
Thank you!
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Rank: Administration
Joined: 11/21/2012(UTC)
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Hi Hollowbrook!
Great question. No, you cannot bill E0486 for the date of service until the seat date. However, if you are a non-participating provider with the insurer, you can of course bill the patient the full amount (or partial, whatever you decide) for treatment up front. It is just important that the date of service for E0486 on the medical claim form be the date that you actually delivered the oral appliance to the patient, since oral appliances for OSA are considered Durable Medical Equipment (DME).
Hope this helps, have a great day!
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