When your child is diagnosed with plagiocephaly, brachycephaly, or severe scaphocephaly, you may be left wondering about the treatment options available. In the most severe cases where physiotherapy and repositioning have been ineffective, orthopedic helmets or bands are prescribed. In this article, we’ll review the different types of braces available, the average cost, and some issues you may encounter if you’re considering this treatment, such as insurance.
If your doctor or physician has recommended the use of a brace to remedy your child’s flat head, your options are numerous. Many smaller orthotic companies produce their own devices, although most in the United States now recommend that their patients use the STAR, Boston Band, or DOC family of products. These companies have become industry leaders due to their ability to offer low-cost, personalized products to large numbers of patients in the US They may work directly with their doctor or through local clinics. In other countries, different manufacturer options are available.
Helmets and bands work on similar principles. Some people choose to distinguish between active and passive orthopedic devices, although for many of the orthopedic devices available today, the difference between the two is negligible. This is, in part, a result of most headbands and headbands being considered passive devices or falling in a gray area between active and passive. The main difference between the two, as currently seen, is the comfort of the fit. Active devices fit better than their passive counterparts. Self-described active orthoses currently in use for the treatment of flat head syndrome include the STARband, STARlight band, STARband bivalve, STARlight bivalve, STARlight cap, DOC band, and the Hanger headband. Passive helmets and bands include the Clarren helmet and the Boston band.
The helmet or band treatment lasts an average of 2 to 4 months and the cost varies widely, from $2,300 to $4,000 per helmet or band. Some children will require more than one brace, depending on the severity of their condition and the type of brace or band used to correct the deformity. Some designs are meant to accommodate the growth of the skull and can be adjusted as your baby grows, while others are expected to be replaced as the skull changes and develops with age. If your baby receives a cranial helmet, she will need to visit the clinic frequently for adjustments, usually every one to two weeks.
Many parents are rightly concerned about the position their insurance company takes regarding their child’s condition. Fortunately, much of the necessary information is available online. To prepare for an insurance claim, you can thoroughly research ICD-9-CM diagnosis codes, HCPCS procedure codes, and your insurance company’s billing practices regarding the treatment of infant flat head syndrome, or plagiocephaly. positional, brachycephaly and scaphocephaly. You may want to check carefully with your orthotic provider before proceeding with treatment to determine how much you will have to cover out of pocket and what their history of cooperating with your insurance company has been. Some clinics only work with a limited number of insurance companies. Sometimes preferring one code over another or using an outdated code can cause major insurance headaches or denial of coverage that would normally have been provided, so it can really help to do your homework.
If you filed an insurance claim for your child’s helmet or headband and were denied coverage because it was considered a cosmetic problem, you can write an appeal letter. The status of plagiocephaly, brachycephaly, and scaphocephaly as actual medical conditions with long-term health ramifications is still ongoing. Many insurance companies have faced lawsuits in recent years and are beginning to recognize the need to cover infants and children with these conditions. Find examples online and reach out to other parents through forums and support groups to reinforce your appeal.
Once you have completed the appeal process, if your company still denies coverage, you can appeal again or look at other financing options. Additionally, there are some non-profit organizations and foundations dedicated to raising funds for children who need treatment for flat head syndrome.
