Wiki Sleep Study Frequency

[lafael03]

I am looking for information regarding a new oral appliance for OSA. The procedure code is E0486. Pt has already had an appliance over 5+ years ago and is due for a new one. She has a new prescription from her PCP. The question is: Is there a timeframe on when the last diagnostic sleep study had to been done? I do not see anything in the guidelines. Thank you!

 

[OpenClaims]

Here is information from CMS E0486, I don't see anything about a timeline for a sleep study. I do see that the patient has to have had a prior sleep study with a qualifying diagnosis. That being said, if your patient had a prior study done and the acceptable Dx, you should be okay to go through with this.