I have frequent questions from parents about insurance reimbursement for bedwetting alarms so I'd like to provide the billing (insurance) code to you as well.
Medical services, procedures and supplies are categorized according to a HCPCS code (Healthcare Common Procedure Coding System). This abbreviation is commonly pronounced Hicks-Picks.
There are 2 levels of codes, Level I and Level II.
Level I codes (CPT) codes identify medical services and procedures.
Level II codes were established in the 1980s as a way to code supplies that are not included in the CPT system but are still covered by and billable to insurance companies. Bedwetting alarms fall into this category.
The HCPCS code for Enuresis Alarms is S8270. (Enuresis and bedwetting mean the same thing).
Enuresis alarms fall into the category of Durable Medical Equipment (DME).
Other things that families need such as nebulizers, crutches, apnea monitors, etc. may also considered to be DME by insurers. Your insurance policy should specify your coverage for DME or you can contact them for this information for your own policy.
If the customer service representative wants to know the HCPCS code, now you have it.
In terms of medical devices, bedwetting alarms are relatively inexpensive. It doesn't seem logical that expensive medications for bedwetting, which can run as much as $10 per night, would be covered but more effective, less expensive bedwetting alarms would not be covered. But all is not logical in the insurance industry!
Flexible spending accounts can certainly be used for items such as bedwetting alarms. More families are setting aside pre-tax dollars for DME items that are not reimbursable by insurers. Using this money for a bedwetting alarm to stop your child's bedwetting will save you many dollars in the long run. The cost of disposable pants and laundry add up over time, not to mention medication co-pays and your child's self-esteem.
It is always a pleasant surprise to find that a product that your child needs is reimbursable by your insurer. Finding out that it isn't covered does not mean that you cannot get it, however.
The majority of families do pay for alarms out-of-pocket, just as they do tutors, sports equipment, braces, and other things that their children need. For the same amount of money that you're currently spending for 5 or 6 packages of pull-ups, your child can begin to use a bedwetting alarm to successfully solve their bedwetting problem. The majority of my patients' families tell me that it is money well spent.
Since bedwetting tends to run in families, most alarms are durable enough to be used by more than one child, whether it is a sibling, cousin or friend. All of the Malem wearable alarms have an inexpensive replacement sensor, so that the part that comes in contact with the urine can be replaced between children. I hope this answers any insurance related questions you may have.
FYI-The Bedwetting Store does not participate directly with the insurers. If your bedwetting alarm is reimbursable, you submit your sales receipt to your own insurer and they send you the check.
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