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  • #1

    Insurance reinbursment for Spincor

    I need more info from you wonderful people. I need to try to get reinbursement for the Spincor brace. Does any one know what a L code is?

    The sentence in the Dr's report reads as follows.

    "The American government already allowed an L code for this brace."

    We have decent Insurance but I think we should be able to get in- Network coverage for the brace.

    Thank you
    Christine
    from CT, USA
    6 year old daughter diagnosed 7/06 33* T9

    Spinecor 8/06 - 8/2012
    8/06 11* 3/07 5*-8/07 8*-2/08 3*
    10/08 1* 4/09 Still holding @ 1*
    10/09 11* OOB 4/10 Negative 6*
    10/2011 Neg.11* IB 11yrs old 0 rotation
    4/2012 12* OOB 0 rotation
    8/2012 18* OOB for 2 weeks. TSLO night time
    2/2013 8* OOB 3 days TSLO nightime
    3/2014 8* Out of Brace permanently
    Tags: None
  • #2
    Dr. Deutchman gave us the code and it was covered by our insurance. Unfortunately, we are only covered for everything out of network. Unless we can get an in-network orthopedic to say that Nicole should wear Spinecor and not a hard brace, we have no case.
    After meeting deductibles, it seems as though we got very little back.

    Melissa
    Melissa
    From Bucks County, Pa., USA

    Mom to Matthew,19, Jessica, 17, and Nicole, 14
    Nicole had surgery with Dr. Dormans on 9/12/07 at Children's Hospital of Phila. She is fused T-2 - L-3

    Comment

    • #3
      Hi Christine,

      I'm not really sure how insurance works in the U.S. i.e., when I hear "in network" and "out of network" it's all gobblygook to me If you get a letter from Dr. Rivard, your physician then I think it should be alright Pat travels from the States to see Dr. Rivard in Montreal and as far as I know was fully reimbursed for the cost of the Spinecor brace.

      I think the reason Melissa didn't get reimbursed for the cost of the spinecor was because insurance companies need a medical doctor's letter and will not accept chiropractors

      hope this helps
      Last edited by Celia; 08-25-2006, 09:32 PM.

      Canadian eh
      Daughter, Deirdre born Oct 2000. Diagnosed with 60 degree curve at the age of 19 months. Serial casting by Dr. Hedden at Sick Kid's Hospital. Currently being treated by Dr. Rivard and Dr. Coillard in Montreal with the Spinecor brace and curve is holding at "2" degrees. Next appointment 2008

      Comment

      • #4
        Pat from USA please read

        Hi Pat

        I am getting ready to send in paper work for insurance reinbusement for a Spinecor Brace. I would love talk to you.

        Thank you Celia for the info
        Christine
        from CT, USA
        6 year old daughter diagnosed 7/06 33* T9

        Spinecor 8/06 - 8/2012
        8/06 11* 3/07 5*-8/07 8*-2/08 3*
        10/08 1* 4/09 Still holding @ 1*
        10/09 11* OOB 4/10 Negative 6*
        10/2011 Neg.11* IB 11yrs old 0 rotation
        4/2012 12* OOB 0 rotation
        8/2012 18* OOB for 2 weeks. TSLO night time
        2/2013 8* OOB 3 days TSLO nightime
        3/2014 8* Out of Brace permanently

        Comment

        • #5
          Dr D's office requested preapproval and filed for me and my insurance paid out of network. I didn't know if insurance would cover out of the country, but would love to know. I believe most did not cover in network. My insurance also wanted MD doctor recommendation to do brace in network.
          Shirley
          Mom to Amanda, 18, Scoliosis T58, previous Spinecor bracing for 9 months before diagnosed with Chiari I CM, and Syringomyelia (Syrinx) SM. CM/SM decompression surgery 12/4/06, Spinal fusion surgery with titanium rods and hardware and full correction 8/1/07 at Texas Scottish Rite Hospital for Children.

          Also mom to Megan, 14, with diagnosis PDD-NOS on the autism spectrum

          Comment

          • #6
            Originally posted by christine2
            Hi PatI am getting ready to send in paper work for insurance reinbusement for a Spinecor Brace. I would love talk to you.
            Christine
            Hi Christine, I responded to your PM, I hope you got it. We did get reimbursement for our daughter's Spinecor Brace. Pat

            Comment

            • #7
              Spincor & Insurance

              Yes I did get your response thank you. I was looking for a way to get in network coverage but that is not going to happen. We sent in our paperwork and feel thankfull that we can at least get something back.


              My kids started 1st grade on Wednesday. Erica is doing great with her brace on. The only problem is she has to go to the nurses offfice to go to the bathroom because her little fingers are not strong enough to do the snaps up. VERY minor issue.

              I feel fortunate that she is so young and there is full compliance!!

              You folks help me get through a difficult time thank you!!
              Christine
              from CT, USA
              6 year old daughter diagnosed 7/06 33* T9

              Spinecor 8/06 - 8/2012
              8/06 11* 3/07 5*-8/07 8*-2/08 3*
              10/08 1* 4/09 Still holding @ 1*
              10/09 11* OOB 4/10 Negative 6*
              10/2011 Neg.11* IB 11yrs old 0 rotation
              4/2012 12* OOB 0 rotation
              8/2012 18* OOB for 2 weeks. TSLO night time
              2/2013 8* OOB 3 days TSLO nightime
              3/2014 8* Out of Brace permanently

              Comment

              • #8
                I was told by one of the Spinecor providers that the L Code is L1005

                I hope this is timely for you.

                Comment

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