The ReBuilder & Neuropathy

 

 

 

The ReBuilder & Neuropathy

 

The ReBuilder and Insurance

Most Private Health Insurance Companies Cover the ReBuilder.

ReBuilder treatments in a clinic and product re-imbursement for home use are routinely covered by most insurance companies under the codes used for electrical stimulation.

ReBuilder is Registered with the FDA for the following uses:

  • Symptomatic Relief for Chronic Intractable Pain

  • Post-Traumatic & Post-Surgical Pain Relief

  • Increasing Local Blood Circulation

  • Muscle Reeducation

  • Relaxation of Muscle Spasms

  • Prevention or Retardation of Disuse Atrophy

  • Immediate Post-Surgical Stimulation of Calf Muscles to Prevent Venous Thrombosis

  • Maintaining or Increasing Range of Motion

 

The ReBuilder qualifies for reimbursement under the "DME Billing Code" E0720.

The ReBuilder is fully registered with the FDA as both a TENS device (DME Code E0720) (for pain) and separately, as an EMS (DME Code E0745) for muscle atrophy with intact nerve.  Most insurance companies recognize, understand, and prefer the TENS description.

* DME = Durable medical Equipment

Although the FDA groups the ReBuilder with normal TENS devices (because of their limited number of classifications) the function of the ReBuilder is exactly the opposite of a common TENS device.  Basic TENS is meant to close nerve channels to block pain, while the ReBuilder is designed to open nerve channels, creating a reversal of symptoms.

 


Unfortunately, Medicare is currently unavailable for coverage. 

Model 300 has been partially covered in the past, however new Medicare regulations have restricted access to this wonderful product.


We do not bill your healthcare provider. You file a claim for reimbursement. **

** On rare occasion, your provider WILL pay us up front for the device.  Contact your provider to inquire about this.

BOTH Models 2407 and 300 are routinely covered.

You do NOT need a prescription to purchase a ReBuilder, but you will need a prescription to provide to your insurance company as part of your claim to get it covered.

Most insurance companies will reimburse you according to the terms of your policy, usually 80-90% of the purchase price. Secondary coverage may pick up the rest. 

Contact your provider if you are unsure if it is covered.  In order to know exactly IF and HOW MUCH will be covered, please contact your healthcare provider and ask "what is my coverage for a TENS device for my chronic pain?   The DME Code is E0730".   If they ask, "Is it a tens device?", you can say yes to confirm that they are looking at the correct code. 

 

The format and codes your physician will need are as follows.

 

Prescription Language Should Include:

1) Diagnosis and (Code):   "chronic intractable pain"   DX Code G89.4    

Other Possible Diagnosis Codes: "Other Chronic Pain" (DX Code G89.29) and "Unspecified Idiopathic Peripheral Neuropathy"  (DX Code G60.9 DX Code 90.09)

2) DME Billing Codes:

ReBuilder Model 300 (DME Code E0720) for treatment of chronic pain.

ReBuilder Model 2407 (DME Code E0730) for treatment of chronic pain.

DME Billing Code E0731 Conductive garment (gloves and/or socks)   Description is: "TENS or NMES with conductive fibers separated from patient's skin by layers of fabric".    And/or... "Area to be treated is too large for the normal electrodes."     And/or... "Patient cannot tolerate the adhesives of normal conductive electrodes."

3) FDA Description:  "TENS, ReBuilder, brand specific, for pain." (no generic substitutions)  

4) Medical Necessity:  "This device is medically necessary for the treatment of intractable pain unresponsive to drugs, surgery, and/or physical therapy.  

 

Optional Paperwork. Can strengthen claim.

History of Failed meds: To further strengthen your claim, we suggest your doctor also include a brief history of failed medications or other attempted modalities.  (This can be part of the "medical necessity" statement.)

Evaluation Study: To further strengthen your claim, we suggest your doctor also include a brief evaluation study showing improvement. sample

 

click here for a printable version of this

 

This is the fasted way to get reimbursed...

1. Confirm coverage with your provider. 
 
2. Talk to your doctor about the ReBuilder and ask if he/she will write the prescription. 
     (If not, find a new physician that has your best interests in mind!)
 
3. Purchase the ReBuilder and then make a copy of your sales receipt to include with your claim.
 
4. Gather the sales receipt, the prescription, and any other supporting documentation, and then submit your claim.

5. Reimbursement is sent to you by your health insurance provider.  

** The need for a "trial use" and a 30-60 day re-evaluation is required for some Insurance Plans.  Some plans will not pay until improvement benefit is documented by your physician. This is why many people use the ReBuilder for 30 days and then share results with their physician, then file the claim. This significantly strengthens your claim.

 

 

 

 

 The ReBuilder