Surgical Treatment of Obstructive Sleep Apnea (OSA)
J5 · Effective Oct 1, 2015
3 active Medicare policies list 21685, and 13 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.
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J5 · Effective Oct 1, 2015
J8 · Effective Oct 1, 2015
J5 · Effective Jan 1, 2026
13 policies from 12 payers
Summary of the payer’s published policy. Not a coverage determination — confirm with the payer before submitting.
| Policy | Effective | Status of 21685 |
|---|---|---|
| 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 21685 |
|---|---|---|
| Obstructive Sleep Apnea in Adults | Mar 13, 2024 | Covered |
| Policy | Effective | Status of 21685 |
|---|
| Oral, Pharyngeal and Maxillofacial Surgical Treatment for Obstructive Sleep Apnea or Snoring | Oct 1, 2026 | Covered |
|---|
| Policy | Effective | Status of 21685 |
|---|---|---|
| Sleep Related Breathing Disorders: Surgical Management | Jan 1, 2026 | Covered |
| Policy | Effective | Status of 21685 |
|---|---|---|
| Sleep Related Breathing Disorders: Surgical Management | Jan 1, 2026 | Covered |
| Policy | Effective | Status of 21685 |
|---|---|---|
| Sleep Related Breathing Disorders: Surgical Management | Jan 1, 2026 | Covered |
| Policy | Effective | Status of 21685 |
|---|---|---|
| Sleep Related Breathing Disorders: Surgical Management | Jan 1, 2026 | Covered |
| Policy | Effective | Status of 21685 |
|---|---|---|
| Obstructive Sleep Apnea and Other Sleep Related Breathing Disorders Surgical Treatments | Jun 1, 2026 | Covered |
| Policy | Effective | Status of 21685 |
|---|---|---|
| Obstructive and Central Sleep Apnea Treatment – Surest Medical Policy | Oct 1, 2026 | Covered |
| Policy | Effective | Status of 21685 |
|---|---|---|
| Obstructive and Central Sleep Apnea Treatment | Oct 1, 2026 | Covered |
| Policy | Effective | Status of 21685 |
|---|---|---|
| Obstructive and Central Sleep Apnea Treatment | Oct 1, 2026 | Covered |
| Policy | Effective | Status of 21685 |
|---|---|---|
| Sleep Apnea Surgical Treatments | Not recorded | Covered |