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    OpenPayerBilling CodesMedical And Surgical SuppliesHCPCS hcpcs-a7027-combination-oral-nasal-cpap-mask
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    HCPCS A7027: Combination Oral/Nasal Mask for CPAP

    HCPCS Level II code A7027 describes a combination oral/nasal mask intended for use with a continuous positive airway pressure (CPAP) device; service type is durable medical equipment for positive airway pressure therapy, and the typical site of service is the patient’s home or sleep laboratory where CPAP therapy is administered.

    For related coverage guidance, see recent payer policy updates: Salivary Hormone Testing, Parathyroid Hormone, Phosphorus, Calcium, and Magnesium Testing, Bone Turnover Markers Testing.

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    Clinical & Coding Specifications

    Clinical Context

    A 58-year-old patient with symptomatic obstructive sleep apnea (OSA) is fitted for positive airway pressure therapy after a diagnostic polysomnography confirms moderate OSA. The respiratory therapist or durable medical equipment (DME) supplier performs a mask fitting visit to select an appropriate interface. The provider documents mask type, fit, leak rates, and patient tolerance. A combination oral/nasal mask A7027 is provided to the patient when nasal-only masks are ineffective due to mouth breathing or when the patient requires oral access and nasal seal simultaneously. Typical workflow: physician orders CPAP/Bilevel therapy and a DME order for supplies; DME performs fitting, trains the patient on device use and mask care, and dispenses the mask with documentation of medical necessity and device compatibility. Follow-up occurs within 30–90 days to assess adherence and efficacy, with potential replacement or adjustment based on wear or patient tolerance.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    95810Polysomnography, sleep staging with total sleep time; unattended home sleep test with type III portable monitorDiagnostic sleep testing that often precedes CPAP prescription and mask fitting.
    95811Polysomnography, sleep staging with total sleep time; unattended home sleep test with type II or in-lab studies (portable or limited channel)Alternate diagnostic study used to confirm OSA before ordering mask/supplies.
    94660Continuous positive airway pressure ventilation (CPAP), initiation and managementProfessional service for initiation/management of CPAP therapy that accompanies mask fitting and patient education.
    99070Supplies and materials (except spectacles), provided by the physician over and above those usually included with the office visitUse when additional disposable supplies or specialized components related to mask fitting are provided in clinic.
    99406Smoking and tobacco use cessation counseling, intermediate, greater than 3 minutes up to 10 minutesCommon counseling that may be provided during a therapy initiation visit to address contributing risk factors; documented separately when applicable.

    Related Modifiers

    6 rows

    ModifierDescriptionWhen to Use
    22Modifier –22 (Increased Procedural Services) is used when a reported procedure is substantially more extensive than normally required. The CPT Manual and CMS state it may be appended only when the…- When to use: Append modifier -22 to a procedural CPT code when the service performed is substantially more extensive than the usual service described by that code — i.e., the procedure required…
    52Modifier ‑52 (Reduced Services) indicates that a service or procedure was partially reduced or omitted at the provider’s discretion, allowing reporting of the basic procedure number with a qualifier…- Use modifier -52 when a physician or qualified health professional electively reduces or omits part of a procedure or service (for example, performing fewer required views or omitting a portion of…
    53Modifier 53 (Discontinued Procedure) signals that a surgical or diagnostic service was begun by the physician but terminated because of extenuating circumstances that threatened the patient’s…- Use modifier -53 when a physician/qualified healthcare professional has started a surgical or diagnostic procedure (e.g., anesthesia administered, incision or scope insertion) and then discontinues…
    62Modifier 62 indicates that two surgeons function as co‑surgeons, each performing distinct parts of the same primary surgical procedure. It is appended to the primary procedure code (and any…- Use modifier -62 when two surgeons act as co‑surgeons (both primary surgeons) on a single definitive primary procedure, each performing distinct parts of the same surgical procedure (append -62 to…
    78CPT modifier -78 indicates an unplanned, related return to the operating or procedure room by the same provider during the global postoperative period. It is appended when treatment for a…- Use modifier -78 when an unplanned, related complication during the original procedure’s global postoperative period requires the patient to return to a formal operating or procedure room and the…
    80CPT® Modifier 80 (Assistant Surgeon) is appended to a surgical CPT code when a physician (MD or DO) provides full, continuous assistance throughout the operative procedure. It is intended only for…- Use CPT Modifier -80 when a physician (MD or DO) serves as an assistant surgeon and provides full, continuous assistance throughout the entire operative procedure; append -80 to the surgical CPT…

    Related Provider Taxonomies

    8 rows

    Taxonomy CodeSpecialtyNotes
    363L00000XNurse Practitioner(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision mak…
    207R00000XInternal Medicine PhysicianA physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults…
    207PH0002XHospice and Palliative Medicine (Emergency Medicine) PhysicianAn emergency medicine physician with special knowledge and skills to prevent and relieve the suffering experienced by patients with life-limiting illn…
    347D00000XTrainAn organization or business licensed to provide passenger train service, including light rail, subway, and traditional services.
    246QL0900XLaboratory Management Specialist/TechnologistTechnologists, Technicians & Other Technical Service Providers · Specialist/Technologist, Pathology
    225600000XDance TherapistThe dance therapist, sometimes called a movement therapist, focuses on rhythmic body movements as a medium of physical and psychological change. Dance…
    225XE0001XEnvironmental Modification Occupational TherapistOccupational therapy practitioners are experts at identifying the cause of difficulties in performance of activities of daily living and instrumental …
    2471C1106XCardiac-Interventional Technology Radiologic TechnologistA radiologic technologist who specializes in cardiac interventional and is appropriately educated and trained, consistent with nationally recognized s…

    Related Payer Policy Updates

    Specialty: Endocrinology1 / 3

    10 rows

    PolicyPayerEffective Date
    Salivary Hormone TestingOscar Health2026-10-01
    Parathyroid Hormone, Phosphorus, Calcium, and Magnesium TestingOscar Health2026-10-01
    Bone Turnover Markers TestingOscar Health2026-10-01
    Testosterone — Coverage Criteria for Measurement and MonitoringOscar Health2026-10-01
    Diabetes Mellitus Testing — Coverage CriteriaOscar Health2026-10-01
    Thyroid Disease TestingOscar Health2026-10-01
    Thyroid Disease Testingblue cross blue shield - louisiana2026-09-15
    Thyroid Disease TestingBlue Cross Blue Shield - New Mexico2026-09-04
    Parathyroid Hormone, Phosphorous, Calcium and Magnesium TestingBlue Cross Blue Shield - New Mexico2026-09-04
    Testosterone laboratory testing and managementPremera Bluecross2026-09-04

    Related Codes

    HCPCS-A4206-STERILE-SYRINGE-1CC-NEEDLE

    HCPCS A4206: Syringe with Needle, 1 cc or Less, Sterile

    HCPCS-A4207-STERILE-2CC-SYRINGE-WITH-NEEDLE

    HCPCS Level II A4207: Syringe with Needle, Sterile 2 cc

    HCPCS-A4208-STERILE-3CC-SYRINGE-WITH-NEEDLE

    HCPCS Level II A4208: Syringe with Needle, Sterile 3 cc

    HCPCS-A4209-STERILE-SYRINGE-WITH-NEEDLE-5CC-OR-GREATER

    HCPCS Level II A4209: Syringe with Needle, Sterile 5 cc or Greater

    HCPCS-A4210-NEEDLE-FREE-INJECTION-DEVICE

    HCPCS Level II A4210: Needle-free Injection Device, Each

    HCPCS-A4211-SUPPLIES-SELF-ADMINISTERED-INJECTIONS

    HCPCS Level II A4211: Supplies for Self-Administered Injections

    HCPCS-A4212-NON-CORING-NEEDLE-STYLET-CATHETER-ACCESS-SUPPLY

    HCPCS Level II A4212: Non-coring Needle or Stylet with/without Catheter

    HCPCS-A4213-STERILE-SYRINGE-20CC-OR-GREATER

    HCPCS Level II A4213: Syringe, Sterile, 20 cc or Greater, Each

    HCPCS-A4215-STERILE-NEEDLE-SINGLE-EACH

    HCPCS Level II A4215: Needle, Sterile, Any Size

    HCPCS-A4216-STERILE-DILUENT-FLUSH-10ML

    HCPCS Level II A4216: Sterile Diluent/Flush, 10 ml

    Showing 1–10 of 633

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    Frequently Asked Questions

    References

    1. 1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
    2. 2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
    3. 3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.
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