S2080, Laser-assisted uvulopalatoplasty (laup)
HCPCS/CPT
Prior Authorization
No Prior Auth Required
No active coverage policies found for this code (low confidence)
Medicare Pricing
Work RVU
0.00
Facility
N/A
Non-Facility
N/A
Documentation Required
- The policy's definitions for obstructive apnea and hypopnea (duration, reduction criteria, and desaturation threshold) must be used when documenting sleep study results.
- DISE findings (presence or absence of concentric/complete circumferential oropharyngeal collapse) are relevant to hypoglossal nerve stimulation eligibility; concentric collapse is an exclusion.
- Definition of CPAP failure: residual AHI ≥15 while on CPAP, or failure to use CPAP ≥4 hours/night for ≥5 nights/week, or inability to tolerate CPAP — documentation required.
- AHI and RDI definitions as specified in the policy must be used to document event rates for eligibility.
Key Coverage Criteria
- Removable oral appliances are proven and medically necessary for treating obstructive sleep apnea (OSA) when a sleep study confirms diagnosis and prior evaluation has occurred.
- Pulmonary hypertension;or
- Documented ischemic heart disease;or
- Impaired cognition or mood disorders;or
- History of stroke;or
- Hypertension;or
9 Active Policies
ANTHEM-SURG.00129, SURG.00129 Oral, Pharyngeal and Maxillofacial Surgical Treatment for Obstructive Sleep Apnea or Snoring
ANTHEM-MED.00002, MED.00002 Selected Sleep Testing Services
UHC-POL-obstructive-sleep-apnea-treatment, Obstructive and Central Sleep Apnea Treatment
BCBSIL-SUR706.009, Sleep Related Breathing Disorders: Surgical Management
BCBSMT-SUR706.009
Related Codes
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