Insurance Jargon Made Simple: Understanding Coverage for Cranial Prostheses

Discover how cranial prostheses may be covered and how we help you navigate the process with ease.

Let’s be honest—insurance language can feel like a foreign language. Deductibles, EOBs, CPT codes—it’s enough to make anyone’s head spin. And when you’re already navigating hair loss from cancer treatments, alopecia, or another medical condition, the last thing you need is more confusion.

That’s why at The Wig Collective, we break down the insurance process into simple, clear steps. Here’s what you need to know about getting your cranial prosthesis (medical-grade wig) covered.

Step 1: Know the Terminology

Insurance companies don’t cover “wigs.” They cover cranial prostheses. Using the right term is key to approval.

Cranial prosthesis: The medical term for a wig designed for people with medical hair loss.
CPT code: The billing code used by your provider (commonly A9282).
ICD-10 code: The diagnosis code your doctor uses to confirm why you need a cranial prosthesis (examples include chemotherapy-induced alopecia or autoimmune-related alopecia).

✨ Tip: Always use “cranial prosthesis” in paperwork, not “wig.”

Step 2: Understand Your Benefits

Your insurance policy may list coverage for “durable medical equipment” (DME) or “prosthetics.” That’s where cranial prostheses usually fall.

Here are some terms you’ll encounter:

Deductible: The amount you pay before insurance starts covering costs.
Co-pay or co-insurance: Your share of the cost after insurance kicks in.
Out-of-pocket maximum: The most you’ll pay in a year before insurance covers 100%.

Step 3: Get a Prescription

A doctor’s prescription is usually required. It should include:

The words cranial prosthesis
Your diagnosis code (ICD-10)
Quantity: 1 cranial prosthesis

Step 4: Submit Documentation

Your insurance claim typically requires:

Doctor’s prescription.
Detailed invoice from your wig provider (The Wig Collective provides these).
Insurance claim form (we help guide you through this).

Step 5: Prepare for Denials (and Appeals)

Sometimes insurance companies deny coverage the first time. Don’t panic—this is common. You can appeal the decision by submitting additional documentation. At The Wig Collective, we provide supporting letters and coding details to strengthen your appeal.

Why Work With a Medical Wig Studio?

Unlike beauty supply shops or online wig sellers, we specialize in medical-grade wigs and know the insurance process inside and out. From helping you request a prescription to submitting the right codes, we’ll walk you through every step.

Final Thoughts

Insurance doesn’t have to be intimidating. With the right terminology, documentation, and support, you can get coverage for your cranial prosthesis and focus on what really matters—feeling like yourself again.

✨ Most insurance plans cover cranial prostheses—we’ll guide you through the process.

📍 Visit us in our Lehi, Utah studio, or let us come to you with our Wigs on Wheels service.
📅 Book your private consultation today: https://thewigcollective.square.site