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Cost of NA by Dr Eaton
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10/30/2009 04:44
Guest

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10/30/2009 04:44
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Re: Cost of NA by Dr Eaton

Quote:



Hi:

I just completed my research about Dr. Eaton and NA. My insurance will not cover the procedure either.

Here is what I found:
Consultation: $300
Each finger treated: $600
Nodule injection: $199/injection

the procedure code is 26040.

I've heard great things about both the procedure and Dr. Eaton, so I think it is worth the investment."
-------------------------------
Hi Linermeyer,

What exactly did your insurance company tell you about not covering the procedure? Which insurance company is it? Do not accept this denial without a fight. Sometimes just telling your company that Medicare covers it is enough. Other times you have to go further especially with an HMO or if using an "out-of network'" doctor. I don't have enough space but I'll do another post with guidelines from Dr. Eaton's website about how to deal with your insurance company (I've had 3 NA procedures and had to fight twice but finally prevailed--keep escalating and filing grievances and if necessary go to your State Insurance Commissioner).

As far as Dr. Eaton and it being "worth the investment"-- I'd probably sell my first born to get the money to be treated by Dr. Eaton and his nurse, Valerie. I've been seen by 3 reputable hand surgeons for DD and had NA with two of them. Not only is Dr. Eaton extremely competent and caring, he takes his time and is extremely thorough; other docs may do several fingers in 45 mins, while Dr. Eaton might take an hour and 45 minutes. Even so, you really can remove the bandaids--that night and bruising and swelling is gone in less than a week. That was not my experience with other surgeons. In addition Dr. Eaton is interested in training (he's trained dozens of docs), research and finding a cure! I cannot praise him enough. He also has a very impressive training manual on his website along with lots of other great information:

http://www.handcenter.org/dupchapter/NAmanual2009.pdf
http://www.eatonhand.com/hw/hw009.htm

Below is the link to the insurance information -see the next post.
http://www.handcenter.org/newfile23.htm

Please contribute to the Dupuytren Foundation and help find a cure. Don't take the chance that your kids will also have to deal with it!
http://www.dupuytrenfoundation.org/

10/30/2009 10:59
brian123

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10/30/2009 10:59
brian123

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Re: Cost of NA by Dr Eaton


I had N.A, with Eaton........not cheap...but you get the best doc ....I would noy even consider anyone else,
You only have 10 fingers and your not getting new ones so take care of the ones you have !

10/30/2009 22:56
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10/30/2009 22:56
Guest

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Re: Cost of NA by Dr Eaton

Sorry I wasn't able to post the info last night. My internet connection was too slow:
• From: http://www.handcenter.org/newfile23.htm


From Dr. Eaton's website-- near the bottom of the page-- info on how to deal with an insurance company that won't cover NA.
• Is this covered by insurance? Yes.
• What do I need to tell my insurance company? Your insurance company will want to know these insurance codes
o ICD Code 728.6 CPT Code 26040 (Percutaneous Fasciotomy - one finger)
o ICD Code 728.79 CPT Code 20550 (Steroid injection Dupuytren's nodule)
and occasionally
o ICD Code 715.14 CPT 20600 (Steroid injection of finger joint)
and even less commonly
o ICD Code 736.21 CPT 26060 (Tendon release for boutonniere deformity).
• My insurance company tells me that they won't cover this because...
o The Hand Center physicians are not providers. The Hand Center physicians are Medicare providers, but not other insurance plans. If our physician is not contracted with your plan, The Hand Center will provide you with the necessary documentation for you to submit to your insurance plan for your later reimbursement - but you will be responsible for payment in full on the day of your office visit (cash, cashier's check, MC, Visa).
o Other surgeons do Dupuytren's surgery. That's true, but if you want a needle aponeurotomy rather than open surgery, ask your plan representative for a list of other providers who perform this procedure, and mention that the total cost of traditional outpatient Dupuytren's surgery, including facility, anesthesia, and therapy will be ten to twenty times that of an office needle aponeurotomy. Mention that twice.
o This is cosmetic surgery, and so is not covered. Absolutely not true. Don't accept this explanation. Correction of contracture has been reported to improve hand function and dexterity lost to the disease (see the publication by Inha R, Cresswell TR, Mason R, Chakrabarti I: Functional benefit of Dupuytren's surgery. J Hand Surg [Br]. 2002 Aug;27(4):378-81). Advanced untreated Dupuytren's contracture has led to finger amputation for some patients, and Dupuytren's alone has qualified some sufferers for permanent complete medical disability. That's not cosmetic, period. Speak with your plan representative's supervisor, get their name, and let them know that you will be naming them personally when you write your insurance commissioner to complain that your plan is using a fraudulent explanation to deny a medically necessary treatment which is covered by Medicare. Contact your state insurance commissioner. "

Please contribute to the Dupuytren Foundation and help find a cure. Don't take the chance that your kids will also have to deal with it!
http://www.dupuytrenfoundation.org/


11/05/2009 14:16
linermeyer@gmail.com

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11/05/2009 14:16
linermeyer@gmail.com

not registered

Re: Cost of NA by Dr Eaton

Thanks for the feedback.

Has anyone out there used Dr. Pess in New Jersey? I was given his name by someone in Dr. Eaton's office when looking for someone more local to NJ/NY area.

Any feedback from your experience would be greatly appreciated.

11/05/2009 15:37
SteveAbrams

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11/05/2009 15:37
SteveAbrams

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Re: Cost of NA by Dr Eaton

Go to the following site to see a successful appeal of a denial of coverage:

http://www.dupuytren-online.info/Forum_E...77&page=1#6

Steve Abrams

11/05/2009 16:03
wach 

Administrator

11/05/2009 16:03
wach 

Administrator

Re: Cost of NA by Dr Eaton

You can use the Search function of this forum to find post on Dr. Pess. There are many, e.g. http://www.dupuytren-online.info/Forum_E...05&page=1#0

Wolfgang

Quote:



Thanks for the feedback.

Has anyone out there used Dr. Pess in New Jersey? I was given his name by someone in Dr. Eaton's office when looking for someone more local to NJ/NY area.

Any feedback from your experience would be greatly appreciated.




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