Re: Need a medical definition of apraxia

[Guest guest]

The book " The Parents Guide to Speech and Language Problems " by Debbie Feit has

a chapter (Ch 11) on fighting for insurance coverage and provides some sample

language you can use. She says diagnostic codes in the 300's are usually

classified as developmental delays and not covered while codes in the 700 range

(784.69 is apraxia) are more likely to be reimbursed. As part of your appeal,

you will need to check what code your OT submitted the claims under and maybe

have her change the code before you resubmit the claims.

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> My daughter was receiving OT services due to her apraxia. The insurance was

paying just fine, but then decided to stop. Now I'm stuck with a bill of approx

1200 that our Therapy place is seeking. I've appealed once, but was denied. I

have to say I was not prepared for that appeal and it was basically done on the

phone without any support to back up my claim. I can do a second appeal but I

want to go in prepared for this. The denial came stating that insurance does

not pay for learning disabilities or developmental delay. She was in OT for

gross motor delays due to the apraxia. I can google definitions all day, but

I'd like a " medical " definition from some physican that states exactly what

apaxia is and what areas it affects. Can someone help me with that? Thank you.

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