Re: OT, PT with associated PIDD fatibue, pain

[Guest guest]

---It may be that the code used would cover the problem, even if it

cannot be covered as related to her PID.

For instance, some children can get OT/PT with " upper body weakness "

or things like that. Often, its just how the request is worded.

My ins, will cover 60 visits per yr with no questions asked. Thats

mixing OT, PT, and ST together.....60 visits total to therapy.

Also, sometimes if you qualify financially, you may be able to get a

state ins as secondary to cover what your ins does not.

Many OT/PT will do a free evaluation at first, to see if your child

will benefit from therapy. At that time, you can ask about your ins

coverage and see if they think it would cover or not.

good luck! My daughter has CVID and sensory processing problems. She

was so often very fatigued and would need to sit down to rest, or

climb into a shopping cart. She often has leg pains that prevent

walking. She went into OT to treat sensory issues, and once we got

into it, her fatigue was greatly lessened. Even things like, holding

her pencil incorrectly the way she used to would fatigue her, bc it

took so much pressure. Little things like learning to hold it properly

and learning better coordination helped her fatigue like you wouldnt

believe. So whether all of that was due to her SPD or the CVID or

both, I dont know, but I know it surely helped her. Cant hurt for you

to give it a try:)

valarie

mom to three with CVID

In , " susan sorensen " <sorensens004@...> wrote:

>

> Hi,

>

> Has anyone been able to get insurance coverage for

occupational/physical therapy to assist with with related PIDD issues?

My daughter has had such terrible fatigue among other things related

to PIDD that it dawned on me she might benefit from some OT or PT to

help build up stamina, strength, etc. Our insurance has that typical

clause of " must have lost function due to illness or injury " , so it

seems it should fit, but dealing with insurance can be a different

world entirely.

>

> Any ideas?

>

>

>

>

[Guest guest]

Thanks Valarie. I know I won't have a problem getting a physician's referral,

but getting the coding correct will be the ticket. My daughter also has sensory

processing issues and apraxia. What ICD9 codes are you using to get her therapy

covered? I posted on another group and someone wrote back that they've

successfully used 781.3 and 315.4

Re: OT, PT with associated PIDD fatibue, pain

---It may be that the code used would cover the problem, even if it

cannot be covered as related to her PID.

For instance, some children can get OT/PT with " upper body weakness "

or things like that. Often, its just how the request is worded.

My ins, will cover 60 visits per yr with no questions asked. Thats

mixing OT, PT, and ST together.....60 visits total to therapy.

Also, sometimes if you qualify financially, you may be able to get a

state ins as secondary to cover what your ins does not.

Many OT/PT will do a free evaluation at first, to see if your child

will benefit from therapy. At that time, you can ask about your ins

coverage and see if they think it would cover or not.

good luck! My daughter has CVID and sensory processing problems. She

was so often very fatigued and would need to sit down to rest, or

climb into a shopping cart. She often has leg pains that prevent

walking. She went into OT to treat sensory issues, and once we got

into it, her fatigue was greatly lessened. Even things like, holding

her pencil incorrectly the way she used to would fatigue her, bc it

took so much pressure. Little things like learning to hold it properly

and learning better coordination helped her fatigue like you wouldnt

believe. So whether all of that was due to her SPD or the CVID or

both, I dont know, but I know it surely helped her. Cant hurt for you

to give it a try:)

valarie

mom to three with CVID

In , " susan sorensen " <sorensens004@...> wrote:

>

> Hi,

>

> Has anyone been able to get insurance coverage for

occupational/physical therapy to assist with with related PIDD issues?

My daughter has had such terrible fatigue among other things related

to PIDD that it dawned on me she might benefit from some OT or PT to

help build up stamina, strength, etc. Our insurance has that typical

clause of " must have lost function due to illness or injury " , so it

seems it should fit, but dealing with insurance can be a different

world entirely.

>

> Any ideas?

>

>

>

>

[Guest guest]

---Sorry, Im not sure which codes were used. Our OT took care of it

all, knew what would go through, and we never had a problem. I hope it

works out for you.

valarie

In , " susan sorensen " <sorensens004@...> wrote:

>

> Thanks Valarie. I know I won't have a problem getting a physician's

referral, but getting the coding correct will be the ticket. My

daughter also has sensory processing issues and apraxia. What ICD9

codes are you using to get her therapy covered? I posted on another

group and someone wrote back that they've successfully used 781.3 and

315.4

>

>

> Re: OT, PT with associated PIDD fatibue, pain

>

>

> ---It may be that the code used would cover the problem, even if it

> cannot be covered as related to her PID.

> For instance, some children can get OT/PT with " upper body weakness "

> or things like that. Often, its just how the request is worded.

>

> My ins, will cover 60 visits per yr with no questions asked. Thats

> mixing OT, PT, and ST together.....60 visits total to therapy.

>

> Also, sometimes if you qualify financially, you may be able to get a

> state ins as secondary to cover what your ins does not.

>

> Many OT/PT will do a free evaluation at first, to see if your child

> will benefit from therapy. At that time, you can ask about your ins

> coverage and see if they think it would cover or not.

>

> good luck! My daughter has CVID and sensory processing problems. She

> was so often very fatigued and would need to sit down to rest, or

> climb into a shopping cart. She often has leg pains that prevent

> walking. She went into OT to treat sensory issues, and once we got

> into it, her fatigue was greatly lessened. Even things like, holding

> her pencil incorrectly the way she used to would fatigue her, bc it

> took so much pressure. Little things like learning to hold it properly

> and learning better coordination helped her fatigue like you wouldnt

> believe. So whether all of that was due to her SPD or the CVID or

> both, I dont know, but I know it surely helped her. Cant hurt for you

> to give it a try:)

>

> valarie

> mom to three with CVID

>

> In , " susan sorensen " <sorensens004@> wrote:

> >

> > Hi,

> >

> > Has anyone been able to get insurance coverage for

> occupational/physical therapy to assist with with related PIDD issues?

> My daughter has had such terrible fatigue among other things related

> to PIDD that it dawned on me she might benefit from some OT or PT to

> help build up stamina, strength, etc. Our insurance has that typical

> clause of " must have lost function due to illness or injury " , so it

> seems it should fit, but dealing with insurance can be a different

> world entirely.

> >

> > Any ideas?

> >

> >

> >

> >