Surgical Treatment of Obstructive Sleep Apnea (OSA)
J5 · Effective Oct 1, 2015
3 active Medicare policies list 21110, and 20 commercial payer policies list it. See each policy's status for the code and its official source. Listing a code is not a coverage decision: read each policy’s source for the requirements that apply.
Free account. Policy pages stay open to everyone.
J5 · Effective Oct 1, 2015
J8 · Effective Oct 1, 2015
J5 · Effective Jan 1, 2026
20 policies from 13 payers
Summary of the payer’s published policy. Not a coverage determination — confirm with the payer before submitting.
| Policy | Effective | Status of 21110 |
|---|---|---|
| Orthognathic Surgery | Jan 1, 2026 | Covered |
| Temporomandibular Joint Disorders | Jan 1, 2026 | Covered |
| Policy | Effective | Status of 21110 |
|---|---|---|
| Orthognathic Surgery | Jan 1, 2026 | Covered |
| Temporomandibular Joint Disorders | Jan 1, 2026 | Covered |
| Policy | Effective | Status of 21110 |
|---|---|---|
| Orthognathic Surgery | Jan 1, 2026 | Covered |
| Temporomandibular Joint Disorders | Jan 1, 2026 | Covered |
| Policy | Effective | Status of 21110 |
|---|---|---|
| Orthognathic Surgery | Jan 1, 2026 | Covered |
| Temporomandibular Joint Disorders | Jan 1, 2026 | Covered |
| Policy | Effective | Status of 21110 |
|---|---|---|
| Cigna Commercial Other Services Code List | Mar 7, 2026 | Prior auth required |
| Cigna Comprehensive Code List | Mar 7, 2026 | Prior auth required |
| Policy | Effective | Status of 21110 |
|---|---|---|
| Obstructive Sleep Apnea and Other Sleep Related Breathing Disorders Surgical Treatments | Jun 1, 2026 | Covered |
| Orthognathic Surgery | Feb 2, 2026 | Covered |
| Policy | Effective | Status of 21110 |
|---|---|---|
| Orthognathic Surgery | Apr 1, 2026 | Covered |
| Prefabricated Oral Appliances for Obstructive Sleep Apnea | Jul 1, 2026 | Covered |
| Policy | Effective | Status of 21110 |
|---|---|---|
| Intra-oral Appliances for Headaches and Trigeminal Neuralgia | Dec 13, 2023 | Covered |
| Policy | Effective | Status of 21110 |
|---|---|---|
| Orthognathic Surgery | Not recorded | Covered |
| Policy | Effective | Status of 21110 |
|---|---|---|
| Temporomandibular Disorders | Oct 1, 2026 | Covered |
| Policy | Effective | Status of 21110 |
|---|---|---|
| Treatment of Temporomandibular Joint Disorders – Surest Medical Policy | Oct 1, 2026 | Covered |
| Policy | Effective | Status of 21110 |
|---|---|---|
| Treatment of Temporomandibular Joint Disorders | Oct 1, 2026 | Covered |
| Policy | Effective | Status of 21110 |
|---|---|---|
| Treatment of Temporomandibular Joint Disorders | Oct 1, 2026 | Covered |