Will my insurance cover Orthomericas cranial remolding orthoses?
Insurance companies and state plans have different criteria for coverage depending on the type of plan and premiums paid. All of these plans require extensive documentation to process the claims including the prescription, letter of medical necessity from the referring physician, proof that repositioning techniques were not successful in correcting the infant s head shape. Additional information, such as, specific measurements and clinical photographs may also be required. You should contact your insurance company prior to your first visit with the orthotist for evaluation and/or casting/scanning for a cranial remolding orthosis. Ask your insurance company if they cover DME (Durable Medical Equipment) and/or cranial remolding orthoses. Cranial remolding orthoses are custom molded devices and carry a specific billing code of S1040 or an undifferentiated code of L1499 or E1399. If your insurance company says that it covers billing code L0100, tell them that the L0100 code is for a protec
