Insurance coverage for scalp cooling is not a standard in the United States. Currently scalp cooling is an out-of-pocket expense. We encourage customers to submit claims in hopes of receiving reimbursement at some level. Many factors contribute to the actual dollar amount received such as medical coding, deductibles, and specific in and out of network coverage on your medical plan.
Here are some important things to know:
- Chemo Cold Caps has no formal agreement with any insurance company. We are considered a third-party out of network provider.
- Chemo Cold Caps Tax ID is 38-3900658 located in Dallas, Texas.
- Chemo Cold Caps does not have an NPI number.
- Chemo Cold Caps does not bill insurance companies. Claims are submitted by the patient after services rendered.
- You must email us to request a detailed paid in full receipt for you to submit to your insurance company.
- Chemo Cold Caps does not generate a form prior to paid treatment.
- Dry Ice is not usually covered by insurance companies.
- YOU MUST OBTAIN A DIAGNOSIS CODE (ICD-10) FROM YOUR PHYSICIAN PRIOR TO CALLING TO CHECK YOUR BENEFITS. Your insurance customer service will ask for this diagnosis code which must be obtained from your doctor. The most common ICD-10 codes are:
- ICD-10 Z51-11 Anti Neoplastic Chemotherapy
- ICD-10 L65.9 Chemo Induced Alopecia
- ICD-10 D09.9 Malignant Neoplasms
- ICD-10 C50.919 Malignant Neoplasm of breast
What you need to do to check your coverage:
- Call your insurance company to check benefits.
- You will need to provide them with your DIAGNOSIS CODE. (ICD-10) that you obtained from your physician.
- They will also want a PROCEDURE CODE (CPT code) Here is a list of CPT codes examples: There are Medical Equipment codes, the representative will want these as well.
- E1399 Durable Medical Equipment Misc,
- A9273 Cold or hot fluid bottle, ice cap or collar, heat and/or cold wrap, any type,
- A9282 Wig
- CPT 97010 Hot/Cold Packs,
- CPT 97039 Constant Attendance Physical Medicine and Rehabilitation Modalities.
- Once you have obtained the correct CPT code and ICD-10 code from your insurance company, we will provide you with an itemized paid invoice that will accompany the claim form that you fill out from your insurance provider. Please email the request and information to me at firstname.lastname@example.org.