How often should a sleep apnea appliance be relined?

The frequency depends on wear and changes in oral anatomy, but typically every 1-2 years or as needed based on patient comfort and appliance fit.

Is a reline covered by insurance?

Coverage varies by insurance plan. It's important to check with the provider to understand specific coverage and frequency limitations.

Can a reline be done in-office?

Yes, a reline can often be performed in-office, but some cases may require sending the appliance to a dental lab, depending on the materials and method used.

What should a patient expect after a reline?

Patients should experience improved fit and comfort. Some may need a short adjustment period to get used to the relined appliance.

D9953

Reline Custom Sleep Apnea Appliance - CDT Code Guide

Adjunctive General Services/Drugs

Overview

CDT code D9953 pertains to the relining of a custom sleep apnea appliance. This procedure involves resurfacing the dentition side of the appliance with new soft or hard base material to restore its original form and function. Typically, this service is required when the appliance no longer fits properly due to wear or changes in the patient's oral anatomy. Dental professionals perform this procedure to ensure the appliance continues to effectively manage sleep apnea by maintaining proper fit and comfort. It is an essential service for patients who rely on these appliances for their sleep health.

When to Use This Code

When a patient's custom sleep apnea appliance shows signs of wear and no longer fits properly.
Following significant dental work that alters the oral anatomy, affecting the fit of the appliance.
When the appliance has been in use for an extended period and requires maintenance to restore its effectiveness.
If the patient reports discomfort or reduced efficacy of the appliance.
After significant weight loss or gain that affects the fit of the appliance.

Documentation Requirements

Detailed patient records indicating the need for relining due to fit issues.
Documentation of the original appliance fabrication and any previous relines.
Clinical notes describing the patient's symptoms and the impact on appliance efficacy.
A description of the materials used for the reline and the method of application.
Patient consent for the procedure, acknowledging the need for relining.
Insurance pre-authorization if required by the patient's plan.

Billing Considerations

When billing for D9953, consider frequency limitations set by insurance providers, as some may only cover relining at specific intervals. Common modifiers may include those indicating the type of material used (soft or hard). It's important to verify coverage with the patient's insurance, as policies on sleep apnea appliances can vary significantly.

Related CDT Codes

D9940 D9944 D9945 D9946 D9951

Frequently Asked Questions

A soft reline uses pliable material for comfort, while a hard reline uses a more durable material for longer-lasting fit and function.

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