Diagnosis codes that insurance will cover?

Discussion in 'General Parenting' started by allhaileris, May 22, 2012.

  1. allhaileris

    allhaileris Crumbling Family Rock

    I have Anthem. daughter's regular doctor sent in a referral for Occupational Therapist (OT) for a sensory diet. Anthem claims the Occupational Therapist (OT) code was right, but that the diagnosis code of 299.0 for autism is "obsolete" (what, did autism just disappear?). I got some weird legalese thing from my insurance stating they'll be covering more Autism Spectrum Disorders (ASD) stuff on July 1, but that doesn't help me now (but I realize I may have to wait). I've been waiting for the docs office to help me with this code for a week and a half. The doctor told me a week ago she'd have the assistant help me with the code, yet the stupid asst called today saying that the Occupational Therapist (OT) place called them saying the insurance wouldn't cover it, and it sounded like my conversation with the doctor didn't get passed along at all.

    I just don't trust them to fix this, and wondered if anybody here had this info?

    I told the asst my daughter's in crisis and I needed both this and a referral to a neuropsychologist (which there is none around) or at least a psychiatrist. I told her I didn't feel like we were being taken seriously. What do I have to do to get them to actually help?
     
  2. SomewhereOutThere

    SomewhereOutThere Well-Known Member

    We always get covered for that. I hear that Pervasive Developmental Disorder (PDD)-not otherwise specified and Aspergers may be gone and it may be Autistic Spectrum Disorder. I haven't heard a thing about autism disappearing. It's sure not going anywhere. Is it possible that OTs are not covered because they aren't doctors?
     
  3. buddy

    buddy New Member

    when do DSM V codes start? I found this but have no clue what it means for NOW...

    No excuse for the doctor not to get on this, seems awful to have them not get that message through. Can you demand to talk straight to the doctor?

    http://www.psyweb.com/DSM_IV/jsp/DSM_VCodes.jsp
     
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