callie raises a good point. I was advised by a hand specialist that my DD, and many cases of DD do not develop into a contraction of the fingers. How to tell though, and what advice to give someone who wants to consider early stage preventive treatment? The other main treatments, Xiaflex, NA, surgery all act on the cords causing the contracture. For some people, musicians perhaps and others the thought of developing a contracture is dismal.

My own experience and decision was based on wanting to actively prevent a contracture. I am an amateur musician, have reduced function in my 'good' non-DD hand, and have active disease as indicated by sore hot inflamed spots with new and developing nodules. So I'm going to ask an expert, the Professor in Germany, for his advice and have the RT if recommended, even though maybe I'll never get a finger contraction if I let it run its normal course. I hope my own thought process, which may be flawed, helps others?

I am like Maddie. BC/BS paid for my RT. No pre-approval needed. Mine was done in Alabama. The paid amount was far less than the billed amount, it was accepted and I didn't owe anything besides my deductible.

As far as the issue callie raised about whether everyone with the early signs of Dupuytren's should seek RT, I think that is a case-by-case call. There are many factors to consider, to name a few:

these indicators could mean a possible aggressive and more recurrent Dup disease:
-early onset (before 50)
-family history
-multiple nodules
-little finger involvement
-nodules in both hands (bilateral disease)
-disease on the radial (thumb) side
-related conditions (Ledderhose, knuckle pads)

how long have the nodules/disease been present?
are there cords present?
is there any contracture/bent fingers?

Most people don't get a diagnosis until they have cords or contracture. I had a small nodule or two for years that were sensitive to pressure, like lifting weights, but I never thought anything about them until I noticed a contracture in my little finger.

Edited 02/17/11 01:36

Lauri,

I went and researched under the search section using criteria of Lori, BCBS and Dupuytren and found a thread where quite a few of us listed our treatment's CPT codes. Here are mine:

Clinical treatment plan: 77263
Field verification simulation: 77280
Simulation complex: 77290
TX device complex: 77334
Weekly mgmt.: 77427
Complex Rad TX: 77413 X 5 days
Basic Dose Calc: 77300
Continuing Med Physics: 77336

I did not need preapproval but I asked the radiation billing dept. to verify my coverage. They verified it while I was being examined by Dr. Crimaldi. It took less than 5 minutes to get verification and approval. Who is verifying your coverage, the radiation dept or your primary doctor? I am asking because if it is the primary doctor that might be where the problem is. I also had the same diagnoses code as yours. I had a MRI because it was standard procedure at the facility I went to. I believe from reading other peoples threads posted here that a CT scan does just as good a job. Believe me the MRI was expensive and while I am glad I had it and they gave me a CD of the MRI so that I have a base line scan that any facility should be able to look at, I will have whatever is the least expensive next time. My BCBS considers a CT scan and MRI as diagnostic tools and they go towards my deductible.

I will be glad to talk to you if needed. Email me on the outside and I will give you my number. Sometimes it is easier and quicker to communicate via phone.

Luba you are exactly right. It is the fear of contraction that looms over every decision I make towards treatment.

Lori

Edited 02/17/11 16:02

lauriw:

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Lori,
This is really great information and this forum is a wonderful tool to get the word out. I sent you a note so that we could correspond further.
As more doctors start doing RT in the US we need to make sure that their names get added to the lists. How do we do that?
LauriW

Thanks so-oooo much Lori. I need these. I will be using them to pursue payment by Medicare.

Scripps is now saying that Medicare didn't pay so they are billing me. Medicare said Scripps did not provide medically needed procedure documentation or justification.

When I called Scripps and told them they paid the first time, she said they wrote it off because it wasn't billed in a timely manner or something like that. I will be working on getting this resolved. Bummer!

Luba, have any issues come up for you about Medicare paying for RT through Scripps?