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Coverage for sleep appliances for Upper Airway Resistance Syndrome (UARS)?

Coverage criteria for treating upper airway resistance syndrome

Great news! We found our first language in a medical policy indicating coverage for custom made oral appliances to prevent airway collapsibility (HCPCS code E0486) for Upper Airway Resistance Syndrome (UARS)! It is from Excellus BCBS, in the policy titled: "ORAL APPLIANCES FOR THE TREATMENT OF SLEEP-RELATED BREATHING DISORDERS". The policy states:

"Based on our criteria and assessment of peer-reviewed literature, oral appliances for the treatment of clinically documented upper airway resistance syndrome (UARS) are considered medically appropriate as treatment option when attempts at behavioral modification have failed."

Here is a link the policy: https://www.excellusbcbs.com/wps/wcm/connect/4bc30f01-e088-451e-a7da-6b3e942ebc0c/mp%2Boral_appl%2Bmpc3%2B17.pdf?MOD=AJPERES&CACHEID=4bc30f01-e088-451e-a7da-6b3e942ebc0c