Download this Medical Insurance Claim Statement Form to help ease the process of obtaining reimbursement from a U.S. health insurance organization for the purchase of a home-use iontophoresis machine (for the treatment of sweaty hands and sweaty feet) from the U.S. manufacturer R.A. Fischer Company. This form should be completed and submitted to the appropriate health insurance organization by your treating physician. You can help your doctor by printing the form and taking it to your next appointment.
You can also look in our Fan Fave page to see if there are any iontophoresis devices that are offering special discounts.
Iontophoresis is a learned technique. Ideally, you perform the technique at home using your own iontophoresis machine after detailed training and practice under a physician’s supervision.
You and your physician may need these codes when filing for insurance coverage:
Iontophoresis Procedure Codes:
97033 - Iontophoresis, each 15 minutes, physicians typically bill for 2-4 units depending on how many areas are treated
99211-99213 - E&M service as applicable
Use -25 modifier if separate identifiable service is rendered
L74.5 - Focal Hyperhidrosis
L74.51 - Primary Focal Hyperhidrosis
L74.512 - Palms
L74.513 - Soles