There is an Invoice Builder feature built into your myDigniCap account. You can use the builder to create an invoice, which you can then submit to your insurance provider. A tutorial for the Invoice Builder can be accessed here: DigniCap Invoice Builder
Although insurance coverage for scalp cooling is not yet standard in the United States, DigniCap patients have submitted insurance claims and received reimbursement for treatment costs at varying levels since DigniCap received FDA clearance in 2015. Success with reimbursement varies depending on plan, coverage, and location and CPT codes do not guarantee coverage.
All information needed is on insurance. Your providers' office may be able to help as well.
If you have a specific question, please send an email to support.
On July 1, 2021, two CPT codes for scalp cooling were issued, however, this type of code may only be used by providers who bill patients for DigniCap treatment. The new CPT codes are not intended for use by patients whose facilities have them purchase a DeltaKit and DeltaCards directly from Dignitana.
Here are some general guidelines for your insurance reimbursement submission:
- You will need to submit a claim form from your insurer
- The ICD-10-CM code on your claim form needs to match the diagnosis code in your medical record. The primary diagnosis code will likely be in the range of:
- 0–C96.9 (Malignant neoplasm)
- C50-56 (Malignant neoplasm of breast or female organs)
- Suggested secondary diagnosis codes are:
- Z51.11 (Encounter for antineoplastic chemotherapy)
- L65.9 (Nonscarring hair loss unspecified)
- For patients filing for reimbursement of DigniCap, suggested HCPCS codes that may be covered are:
- E1399 (durable medical equipment)
- A9273 (Ice cap, cold wrap or pack)
- Ask your physician for a Letter of Medical Necessity printed on your physician’s letterhead.
- Journal of the American Medical Association (JAMA) published scalp cooling study. - CLICK HERE to view the abstract
- Oncology Research and Treatment published study on Scalp Cooling - CLICK HERE to view the abstract
- Ask your doctor for progress notes that reference that you are using scalp cooling to include with your claim.
- Reimbursement may require multiple communications (by phone and writing) with the insurance company.
- Dignitana has no formal agreement with any Third Party Payer (insurance company) and therefore not able to bill a third party payer on behalf of the patient for the scalp cooling services.
- Please visit www.dignicap.com/insurance for insurance updates.