Summary & Overview
HCPCS S8262: Mandibular Orthopedic Repositioning Device
HCPCS Level II code S8262 represents a mandibular orthopedic repositioning device billed per item. These devices are used to reposition or support the lower jaw in dental and maxillofacial care, with applications in orthodontics, temporomandibular disorder management, and preoperative or postoperative stabilization. Nationally, accurate coding for such durable devices affects device coverage determinations, claims routing between medical and dental benefits, and payment consistency across payer networks.
Key payers discussed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find an overview of clinical context for the device, the typical sites of service where it is supplied, and what to expect when submitting claims for this HCPCS Level II code. The publication also summarizes common billing considerations and benchmarks where available, highlights policy updates that influence coverage scope, and outlines documentation elements commonly required by payers.
This resource is intended to give clinicians, billing professionals, and policy analysts a concise reference on HCPCS Level II code S8262, its clinical role, and the payer landscape relevant to device billing and coverage. Data not available in the input will be explicitly noted in the relevant sections.
Billing Code Overview
HCPCS Level II code S8262 denotes a mandibular orthopedic repositioning device, each. This device is used to alter or support the position of the mandible (lower jaw) for orthopedic and dental purposes.
Service Type: Orthopedic/dental positioning device
Typical Site of Service: Dental offices, oral surgery clinics, and outpatient specialty clinics
Data not available in the input.
Clinical & Coding Specifications
Clinical Context
A patient with symptomatic mandibular malocclusion, temporomandibular joint (TMJ) dysfunction, or postoperative mandibular instability is referred to an oral and maxillofacial surgeon or dental specialist for evaluation. After clinical examination and imaging (panoramic radiograph and/or CBCT) confirm a need for mandibular repositioning, the provider fabricates or prescribes a mandibular orthopedic repositioning device to advance, stabilize, or reposition the mandible. The device, reported with S8262, is supplied to the patient during an outpatient visit in a dental clinic, oral surgery office, or ambulatory surgical center. Typical workflow: patient evaluation and diagnosis; impressions or intraoral scanning; device fabrication either in-office or by a dental laboratory; device delivery and fitting; patient instruction for use, care, and follow-up. Follow-up visits assess fit, symptom relief, and adjustments; additional procedures (e.g., occlusal equilibration, TMJ injections) may occur depending on response.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
25 | Significant, separately identifiable evaluation and management service by the same physician on the day of a procedure | Use when an E/M visit is distinct from the device delivery visit on the same day |
59 | Distinct procedural service | Use when reporting a separate, distinct service unrelated to the device application on the same day |
76 | Repeat procedure or service by same provider | Use if the device delivery or fitting is repeated during the same encounter after an earlier attempt |
77 | Repeat procedure by another provider | Use if another clinician repeats the delivery or fitting |
22 | Increased procedural service | Use when substantially greater work is required for fabrication, fitting, or modification |
52 | Reduced services | Use when a component of device delivery is partially reduced or not performed |
27 | Multiple outpatient hospital E/M same day | Use in outpatient hospital settings when billing separate outpatient E/M for the same day as device supply |
RT | Right side | Use if device or service is specifically side-designated and payor requires laterality (rare for bilateral mandibular device) |
LT | Left side | Use if device or service is specifically side-designated and payor requires laterality (rare for bilateral mandibular device) |
GN | Services delivered under an approved home health plan of care | Use if device is furnished as part of home health services |
| Taxonomy Code | Specialty | Notes |
|---|---|---|
1223P0001X | Oral and Maxillofacial Surgery | Common specialist for evaluation, prescription, and delivery of mandibular repositioning devices |
1223D0001X | Dental Public Health / General Dentistry | General dentists or prosthodontists involved in device fabrication and fitting |
1223G0300X | Prosthodontics | Prosthodontists fabricate and adjust orthopedic oral appliances |
103K00000X | Physical Therapist | May be involved in TMJ functional therapy and device-related rehabilitation |
Related Diagnoses
| ICD-10 Code | Description | Clinical Relevance |
|---|---|---|
M26.60 | Temporomandibular joint disorder, unspecified | Common indication for mandibular repositioning device to address TMJ pain/dysfunction |
M26.69 | Other temporomandibular joint disorders | Includes specific TMJ diagnoses where an orthopedic device may be used |
K07.6 | Dentofacial anomalies, unspecified | Mandibular malposition or occlusal problems treated with repositioning appliances |
F45.22 | Persistent somatoform pain disorder, face, head and neck | When chronic facial pain has musculoskeletal TMJ contribution addressed by device therapy |
M26.80 | Other specified disorders of jaw, not elsewhere classified | Miscellaneous jaw disorders managed with orthopedic repositioning |
Related CPT Codes
| CPT Code | Description | Relationship to This Procedure |
|---|---|---|
70336 | CT scan, maxillofacial area; without contrast material | Used when advanced imaging is needed for surgical planning or complex repositioning |
70360 | Magnetic resonance imaging, temporomandibular joint, without contrast | Used for detailed TMJ soft-tissue assessment prior to appliance therapy |
99213 | Office or other outpatient visit for the evaluation and management of an established patient, typically 15 minutes | Common E/M code used for evaluation and device delivery/follow-up when an E/M is billed |
41899 | Unlisted procedure, dentoalveolar structures | Used rarely when a specific oral appliance-related procedure lacks a dedicated CPT and an unlisted code is required |
21050 | Excision of benign lesion or foreign body of the mandible, simple | Performed rarely in the same patient if concurrent minor intraoral surgical procedures are needed prior to device fitting |