Guest guest Posted March 31, 2001 Report Share Posted March 31, 2001 , I went through this last summer. This is a very harrowing road. We live in MI and have BCBS-PPO. They refused payment after much discussion and documentation from doctors of my sons dx. I realize that getting this type of benefit depends upon your employer and the contract between the employer and the health care provider. Therein lies the key. Try talking to a human resource person at your (or husbands) company regarding this coverage. We were trying to get Occupational therapy for our son, and BCBS basically said they do not cover " congenital disease " . Do ya love that?? Anyhow, these are the codes that our neuro-psychologist gave us: 315.4 Developmental Coodination Disorder; 783.4 Developmental Delay. At the time of evaluation (1999) my son was too young to label AS. We re-eval in two weeks. BCBS went on to say that 783.4 was a medical condition and had " ill-defined conditions " . Like I said: do ya love that?? I don't know about you but I have a hard time defining ANY of my sons behaviors/conditions or whatever we like to call them!! I wish you much luck - be persistant. I began this journey last August and did not receive any REAL answers until November. Dawn Quote Link to comment Share on other sites More sharing options...
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