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Need procedure code that will be accepted by my insurance company

Posted by Dawn T. on 10/02/00 at 16:08 (029611)

Help!!!

I need a procedure code that will be accepted by my insurance company (Anthem Blue cross/Blue Shield Century Preferred) to have orthodics paid for by them - otherwise it is $400 out of my pocket. I have Plantar Facitis and Fibromyalgia - so I really need them. Can someone help???

Thanks,

Dawn

Re: Need procedure code that will be accepted by my insurance company

Dr. Zuckerman on 10/02/00 at 18:53 (029633)

There is alot of coding . It depends on the specific insurance company. Your doctor or whoever you purchased the inserts from should give you both the codes and a letter detailing the need for them.
I can help you. Do you know if your insurance policy has a provision to pay for orthosis. You have to call them and ask them If you tell you just send it in. That isn't the right answer They either know or they don't know . So what I trying to avoid is giving you codes and then the insurance company telling you the codes are wrong. They know which codes they cover for orthosis. They may not want to tell you.

Re: Need procedure code that will be accepted by my insurance company

Dawn T. on 10/03/00 at 08:04 (029670)

Thank you for being so willing to help.

When I called the insurance company ( Anthem Blue Cross/Blue Shield Century Preferred of CT ) they told me some orthodics are covered some are not. They wouldn't tell me which were - meaning they wouldn't give me the codes that were acceptable. So how do I find out from here? (Do you need additional insurance information to be able to help me further? http://www.anthem-inc.com)

My feet feel like I am walking on huge puffy blisters by the end of the day and the pain begins to travel up my calves to the point I cannot walk. Morning is hell - I did try the heat pack suggestion this morning and it offered some relief. Currenly I have a desk job - but in less than six months I will be a liscenced massage therapist and on my feet all day - I think using the orthodics will be crucial in keeping some of the pain at bay. I massage my own feet and stretch consistently.

Thank you for all of your help. I truly appreciate it.

Sincerely,

Dawn Tierno

Re: procedure code

alan k on 10/04/00 at 08:25 (029752)

chances are the difference between covered and non-covered orthotics is that non-covered orthotics are those for people with congenital foot irregularties, while covered orthotics are for injuries sustained while covered by insurance. So, much will depend on the diagnosis, so get that straightened out, if possible, as a sudden injury.

hope this helps,

alan k

Re: Need procedure code that will be accepted by my insurance company

Dr. Zuckerman on 10/02/00 at 18:53 (029633)

There is alot of coding . It depends on the specific insurance company. Your doctor or whoever you purchased the inserts from should give you both the codes and a letter detailing the need for them.
I can help you. Do you know if your insurance policy has a provision to pay for orthosis. You have to call them and ask them If you tell you just send it in. That isn't the right answer They either know or they don't know . So what I trying to avoid is giving you codes and then the insurance company telling you the codes are wrong. They know which codes they cover for orthosis. They may not want to tell you.

Re: Need procedure code that will be accepted by my insurance company

Dawn T. on 10/03/00 at 08:04 (029670)

Thank you for being so willing to help.

When I called the insurance company ( Anthem Blue Cross/Blue Shield Century Preferred of CT ) they told me some orthodics are covered some are not. They wouldn't tell me which were - meaning they wouldn't give me the codes that were acceptable. So how do I find out from here? (Do you need additional insurance information to be able to help me further? http://www.anthem-inc.com)

My feet feel like I am walking on huge puffy blisters by the end of the day and the pain begins to travel up my calves to the point I cannot walk. Morning is hell - I did try the heat pack suggestion this morning and it offered some relief. Currenly I have a desk job - but in less than six months I will be a liscenced massage therapist and on my feet all day - I think using the orthodics will be crucial in keeping some of the pain at bay. I massage my own feet and stretch consistently.

Thank you for all of your help. I truly appreciate it.

Sincerely,

Dawn Tierno

Re: procedure code

alan k on 10/04/00 at 08:25 (029752)

chances are the difference between covered and non-covered orthotics is that non-covered orthotics are those for people with congenital foot irregularties, while covered orthotics are for injuries sustained while covered by insurance. So, much will depend on the diagnosis, so get that straightened out, if possible, as a sudden injury.

hope this helps,

alan k