Recently, the four area DME MACs published draft Local Coverage Determinations (LCDs) addressing oral appliance therapy for obstructive sleep apnea. These four policies took effect Jan. 3, 2011:

The LCDs clearly outline the role of the referring physician (MD or DO) in the delivery of oral appliance therapy:

  • The patient must have a face-to-face clinical evaluation by the physician prior to the sleep test to assess the patient for OSA.
  • The device must be ordered by the treating physician following the review of the report of the sleep test.

The LCDs additionally require that the physician (MD or DO) interpreting the sleep test hold either:

  • ABSM sleep medicine certification;
  • ABMS sleep medicine certification;
  • Completed ABMS member board approved residency or fellowship training who has completed all requirements for sleep medicine certification; or
  • Active staff membership of a sleep center or lab accredited by either the AASM or The Joint Commission.

Also noteworthy, the LCDs indicate that no aspect of a home sleep test (HST) may be performed by the dentist supplying the oral appliance. This includes but is not limited to delivery and/or pickup of the device. Please read the LCDs in their entirety, as this article provides only a brief summary.