What is TAP PAP therapy?
customTAP PAP is a hybrid therapy mask that combines a customTAP oral appliance with a nasal pillow CPAP mask.
It provides several key benefits:
- Enables diligent patient monitoring via PAP compliance monitors
- Lowers CPAP pressure settings
- Strap-free design enhances comfort while providing a secure seal
- customTAP oral appliance pulls the lower jaw forward to open up the airway
- Treats mild to severe OSA
How do you choose which patients should do combination TAP PAP therapy?
We typically don’t choose patients; the patient is selected by the process.
If a patient is referred to my practice and we recommend oral appliance therapy, we will measure efficacy using a home sleep study and titration. Perhaps the snoring, sleep quality and energy has improved but their numbers are not where they need to be in regards to nadir, oxygen level, tinnitus, AHI, ERI, ODI, etc… At that point, we would incorporate the PAP therapy to the TAP appliance.
What kind of success have you seen using TAP PAP in your practice?
We have had a great deal of success, where almost all our patients get below a threshold of five (five events per hour). CPAP is considered successful if the device reduces AHI to less than 5 and be more than 50%.
Does treating with TAP PAP have a positive effect on physician relationships?
Sleep physicians will refer patients to our practice specifically for TAP PAP therapy. They are happy with the product innovation – there is no strap around the face making it more comfortable for the patient; plus, they can track compliance and continue monitoring their patients.
As a reminder, physicians are required to have a letter of medical necessity prior to us filling the prescription (i.e. taking scans or doing a consult).
“Working with Dr. Paz and the TAP PAP seamlessly merges two established therapies. We gain invaluable insights into patient compliance and therapy effectiveness through already established monitoring capabilities. Its unique design integrates the benefits of oral appliance therapy and positive airway pressure, ensuring comprehensive treatment for our patients.”
Alex Mckinlay, MD, Board Certified Otolaryngologist & Sleep Medicine, COLONEL, Director Sleep Surgery, Joint Base San Antonio
How do you bill insurance when a patient is using TAP PAP CS?
We bill A7034, and that is a nasal pillow.
For some patients, this is completely independent. Commercial payors vary coverage from one to the next.
Can you bill insurance for both therapies (CPAP and oral appliance)?
Historically, no. I would encourage you to have the patient advocate for themselves and contact the insurance company to see if the A7034 code would be covered. Payers have different standards of coverage based on compliance, CPAP tenure, rental agreements, etc.
What are your top tips for dentists new to TAP PAP CS?
Like most things in dentistry, do a trial with one of your assistants, team members or a loved one. You can order the TAP PAP quite easily and fit them.
Use the tissue test for patients to visualize any leakage from the nasal component and highlight the condensation and bias flow. Leveraging TAP PAP can build trust with complicated cases with improved patient outcomes which will result in more referrals.
