I’m in the middle of a long post about going to Eric’s college for freshman orientation, but I had to pop in to say…my cochlear implants just got approved!!!!
Paige went out to get the mail and the letter was there. It’s kind of hard to understand (and that’s saying a lot because deciphering insurance used to be part of my job when I worked in Human Resources) but I think it’s approved BOTH cochlear implants. It says:
Coverage Decision for Cochlear Device Implantation - 1 time(s): Coverage for this service has been approved
and then it says
Coverage Decision for Cochlear Device - 2 time(s): Coverage for this service has been approved
It also gives approved coverage decisions for “Comprehensive audiometry threshold evaluation and speech recognition”, “Diag analysis of cochlear implant” 1 times(s) (and it has that listed twice, on separate lines so I assume it’s for each CI), and then “Treatment of speech, language, voice, communication, A/O Auditory Process Disorder”.
So I don’t know 100% for sure, but it sounds like they’ve approved the simultaneous bilateral CI’s…I assume that’s why they’ve approved one implantation and two devices.
Whooooo! Dave is at the dentist so he doesn’t even know yet!
YAY YAY YAY 
Woohoo! The insurance obsticle can be the biggest one sometimes. Full steam ahead.
So happy to hear this! Congratulations on this amazing news!
Great news, Wendi! Sounds to me like ya may be getting three (3) CI’s if you add this together!
That’s great news! Keep us posted as you start jumping through the “pre-surgical” hoops!
Congrats!
Wow that is fantastic!
Great news, Wendi!! Now we can both have an “approval party.” Happy dancing here, all over the blog. Wink.
I didn’t doubt that they’d approve it.
Glad to hear it. My insurance letter says “in 90 days” so I guess that means that the approval time is within the next three months or I’ll have to go through the approval process again.
So happy for you.
Woooooo hooo! Thats is wonderful news!
Woo hoo! Great news.
As far as the codes go on your specific approval letter, the two that I commonly see billed which are not listed are 95920 and 95867 for the use of the facial nerve monitor. Insurers used to not have a problem covering these codes, now they are denying them pretty regularly. You should ask your surgery coordinator if the facial nerve monitor is being used for your son’s surgery, if yes, why the codes weren’t preauthorized, and if there is a guaranteed amount that you will pay out of pocked if the FNM is used and the insurance doesn’t pay for it. Of course it is appealable
10 major US insurers now cover both sequential and simultaneous bilateral cochlear implants for children and adults, primarily through the efforts of the Let Them Hear Foundation Advocacy Program. This represents just over half (158 million) privately insured US residents. If you are in the half that is NOT covered and have either a written denial letter from your insurer or a contract exclusion, please submit an application for assistance at http://advocacy.letthemhear.org