Iontophoresis Insurance Help

Since iontophoresis is recognized as medical therapy for the treatment and control of hyperhidrosis, some health insurance companies may cover a portion of the costs.

Patients typically purchase an iontophoresis device and then obtain a reimbursement directly from the insurance company. It is recommended that patients and/or medical providers contact the insurance carrier prior to device purchase to obtain pre-authorization.

Links to some major policies are provided here as well as information about the support iontophoresis device companies can provide:

• Aetna’s Insurance Policy on Iontophoresis for Hyperhidrosis  
• Cigna’s Insurance Policy on Iontophoresis for Hyperhidrosis
• RA Fischer provides an Insurance & Physician Packet complete with all necessary forms so that medical professionals may assist their patients in obtaining iontophoresis insurance coverage or reimbursement. RA Fischer works directly with major insurance providers, including Tricare, Aetna, Horizon BCBS and more to file prior-authorizations and claims on patients' behalf.  In addition, RA Fischer has a dedicated team of Treatment Specialists that can review patients' insurance eligibility over the phone.
• Hidrex USA: provides an Insurance Reimbursement Assistance Guide. 
• Dermadry: provides its Insurance Reimbursement Guide.
  
• Patients can also look on our Fan Fave page to see if there are any iontophoresis devices that are offering special discounts. Periodically, they do.

Treating clinicians may need the codes below when assisting patients with insurance coverage:

Iontophoresis Procedure Codes:

97033 - Iontophoresis, each 15 minutes, clinicians typically bill for 2-4 units depending on how many areas are treated.
99211- Pertains to an evaluation and management (E/M) service. Defined as an office or other outpatient visit “that may not require the presence of a physician.” Usually, the presenting problem(s) are minimal. Typically, five minutes are spent performing or supervising these services.
99213 -  Can be utilized for a mid-level outpatient or inpatient office visit. It is a level three code that should be used for an established patient.
Use -25 modifier for significant, separately identifiable evaluation and management service by the same clinician on the same day of the procedure or other service.

ICD-10 Codes: 

For reimbursement purposes use the more specific codes when possible:

L74.512 – Primary focal hyperhidrosis, palms

L74.513 – Primary focal hyperhidrosis, soles

L74.510 - Primary focal hyperhidrosis, axilla

L74.5 - Focal hyperhidrosis

L74.51 - Primary focal hyperhidrosis

L74.52 Secondary focal hyperhidrosis
L74.8 Other eccrine sweat disorders
L74.9 Eccrine sweat disorder, unspecified

Keep in mind that iontophoresis is a learned technique. Ideally, patients perform the technique at home using their own iontophoresis device after detailed training and practice under your (or your staff's) supervision. Patients can find tips on making the most of iontophoresis here.