Coverage decision assigns TheraSnore a Medicare code

Dental Products Report, Dental Products Report-2014-12-01, Issue 12

The Pricing, Data Analysis, and Coding (PDAC) Contractor and each of the four Durable Medicare Equipment (DME) Medicare Administrative Contractors (MACs) have assigned TheraSnore from Distar a Medicare code.

The Pricing, Data Analysis, and Coding (PDAC) Contractor and each of the four Durable Medicare Equipment (DME) Medicare Administrative Contractors (MACs) have assigned TheraSnore from Distar a Medicare code.

It was determined that the appropriate Medicare Healthcare Common Procedural Coding System (HCPCS) code to use when billing for Distar’s Adjustable TheraSnore product range is E0485.

In order to be designated code E0485, the oral appliance/device is used to reduce upper airway collapsibility, adjustable or non-adjustable, prefabricated, including fitting and adjustment.

“Distar appreciates the timely decision made by the PDAC and the DME MACs and especially the Centers for Medicare and Medicaid Services clinicians involved in reviewing Distar’s evidence based application,” said Rick Mondick, Distar’s owner and president. Distar would also like to thank all the individuals, associations and groups for their continued efforts to develop new standards of practice to help those with this chronic disease.”

The Adjustable TheraSnore is a custom appliance that ustilizes a greater vertical opening and sturdy design. The appliance is fit in the dentist's office in approximately 30-45 minutes, and is reportedly 93% effective in treating mild to moderate obstructive sleep apnea and simple snoring.

It can be adjusted in 1.5mm increments, and is available in three different arch sizes. For patient convenience, the TheraSnore appliance is also easy to maintain and keep clean. Other TheraSnore models (the original TheraSnore and TheraSnore II) are also available.