DSM-IV and SPD

[Rose-Roget]

DS was dx'd with SPD by 2 OT's.  They code him under "Developmental Coordination Delay."  Insurance has denied our claims.  I talked to our ped. who said that usually insurance wants a dx from a developmental ped or psych before they will pay.  But if SPD is not in the DSM-IV, they couldn't "officially" give an SPD diagnosis either, right?  So how do people get the diagnosis?  Is it that the dr's tell you that it's SPD and they code it as something else that is a similar, qualifying disorder?

Also, does anyone know what the final word about SPD in the DSM-V is?  Was it finally accepted or not? 

[KCMichigan]

I dont know how they code it...my DD had OT for SPD and had OT through the school for SPD. BUT she also had a CP diagnosis.

The schools nor insurance would have covered 'just' SPD. Both the schools and private insurance offered it due to her gross motor delays. Although the OT did SPD activities---she did not have any fine motor delays that would otherwise merit OT.

I wish you luck, SPD is tough to get covered if it is the only dx.

[fallenangel811]

My son was dxed with developmental coordination disorder and SPD. Hehas fine and gross motor delays and insurance wouldn't cover OT for him. At 3.5 his fine motor skills ranged from 20 months to 33 months. I think his gross motor was 30-36 months.

Good luck - hope it ges better for you than it did for us!!

[LynnS6]

Our OT suggested two diagnoses:

1. Disorders of the nervous system (unspecified) (349.9)

2. Motor incoordination/ataxia (781.3)

It worked for our insurance company

[beachbaby]

Our OT gave a diagnosis of "neurological neglect syndrome" for DD's SPD and fine motor delays. Not sure if that's what the dx is actually coded as, but I think it is.

[blessedwithboys]

motor incoordination and mild hypotonia here

but insurance ended up not being an isue bc we got the worlds best OT through the local Elks Lodge