What is Cold Cap Therapy?
Cold Cap Therapy, or scalp cooling, involves the use of a special cap or set of caps, cooled to very cold temperatures, and worn for a period before, during and after each chemotherapy treatment. It is believed that the cold temperature constricts the blood vessels leading to the hair follicles, reducing the amount of chemo drugs that reach the follicles during the period that the caps are worn; also, that the cold puts the follicles "to sleep," temporarily limiting their metabolic activity. (Of note, the drugs stay in the patient's system far longer, but reach the hair follicles when they are at somewhat diluted strength.) This process has been in use in Europe for over 20 years. Many thousands of patients in the United States have learned of and successfully used Cold Cap Therapy in the last few years.
Penguin Cold Caps
Our experience is solely with using Penguin Cold Caps.
https://penguincoldcaps.com/cold-cap-info/are-cold-caps-covered-by-insurance/
For more information on Penguin Cold Caps, visit their website:
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Other Cold Cap Options
There are several other Cold Cap options, including both machine capping systems and manual capping systems. For an overview of the options, visit The Rapunzel Project website which provides details:
Videos of Cold Capping
Two videos below showing how to use Penguin Cold Caps. The first is Shannon capping Marci. The second is a video someone else posted on YouTube that we thought was very helpful.
Can I get Insurance to Pay for Cold Caps? The answer is sometimes YES!
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The cap suppliers are considered a third-party out of network provider.
You must submit the claim to your insurance company – they will not bill your insurance.
Step 1.
Before calling your insurance to check your benefits. You must have your Diagnosis Code from your Physician. It’s also referred to as a ICD-10 code.
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Common codes used for this are:
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ICD-10 Z51-11 Anti Neoplastic Chemotherapy
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ICD-10 L65.9 Chemo Induced Alopecia
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ICD-10 D09.9 Malignant Neoplasms
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ICD-10 C50.919 Malignant Neoplasm of breast
Step 2.
Call your Insurance provider to check your benefits & obtain a claim form. It may be worth asking your provider if they require preauthorization for Scalp Cooling/Cold Capping. You will need to provide them with ICD-10 code from your Physician.
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Note: You need to check if they will cover you for any of the following codes:
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A9273 – Cooling Caps, Cold/Hot Wrap or Pack
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A9282 – Wig any type, Cranial/Scalp Prothesis
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E1399 – Durable Medical Equipment Misc.
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97010 – Hot/Cold Packs
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97039 – Service
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99070 – Supplies and materials provided by the physician or other qualified healthcare professional (Dry Ice)
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97039 – Constant Attendance Physical Medicine
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0662T – Scalp cooling, mechanical; initial measurement and calibration of cap
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0663T – Scalp cooling, mechanical; placement of device, monitoring, and removal of device (List separately in addition to code for primary procedure)
Step 3.
Now you know if they will cover you & what CPT & ICD-10 code to use.
Fill out the form your insurance company has provided.
Step 4.
Email: support@penguincoldcaps.com & we will provide an itemized statement for you to include with your insurance claim form.
You should know that you can try to claim for dry ice, as it is required to use our system – although reimbursement does vary.
Make sure you keep your receipts for each purchase & submit it with your insurance claim.
Note: Sometimes it good to include a progress note from your physician, referencing the use of scalp cooling.
Note: We cannot contact your doctor or your insurance to assist due to HIPPA Privacy Laws