Rank: New Member
Joined: 1/14/2013(UTC)
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I have submitted a claim to United Health Care for an Oral Sleep Appliance. We've spplied codes 327.23 (diagnosis) and E0486 (service). The insurance company is requiring, what they've told me is, a modifier code. They have stated that they follow the Medicare guidlines and that a modifier code is required in this scenerio.
Any suggestions as to what code I should submit?
Thanks
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Rank: Administration
Joined: 11/21/2012(UTC)
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Hi dentlc01!
The two modifiers that Medicare requires for E0486 are:
NU - to indicate the oral appliance is new durable medical equipment
KX - to indicate the patient meets all Medicare qualifying criteria for E0486 (i.e. diagnosed with OSA AHI 5+, if severe has tried and failed CPAP, etc)
Hope this helps!
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