How to Submit an Insurance Claim for a Wig Prosthesis or Cold Capping

— A Re-Femme Guide for Women Navigating Insurance for the First Time

One of the first overwhelming tasks many women face after a cancer diagnosis is navigating insurance — especially when it comes to covering a wig prosthesis (also called a cranial prosthesis) or cold capping.

If you’ve never submitted a medical claim before, you are not alone. Most of us are learning as we go, in the middle of treatment, fear, and fatigue. This guide will help you understand what to ask for, what documents you’ll need, and how to increase the chances of getting reimbursed.

And remember: you deserve support. These services aren’t “extras” — they’re legitimate, medically recognized tools that help women preserve dignity, identity, and emotional well-being during cancer.

Step 1: Call Your Insurance Company Before You Buy Anything

Every insurance plan is different. Some cover wigs under “cranial prosthesis,” others under “durable medical equipment,” and some reimburse only with specific documentation. Cold capping is sometimes partially covered under “scalp cooling therapy.”

Ask these questions before purchasing:

• Does my plan cover a cranial prosthesis (medical wig)?
• What billing code should my provider use? (Common: A9282 for cranial prosthesis.)
• What documentation do you require for reimbursement?
• Is there a dollar limit or maximum allowed amount?
• Does my plan cover cold capping or scalp cooling therapy?
• If so, what CPT or HCPCS code should I use?
• Do you require pre-authorization for either service?

Write everything down — including the name of the representative you spoke with. It helps tremendously if you need to appeal later.

Step 2: Get the Right Prescription From Your Oncologist

Insurance companies almost always require a prescription or letter of medical necessity for both wigs and cold capping.

Your doctor’s note should include:

• Your diagnosis (ICD-10 code for cancer and chemotherapy-induced alopecia, often L65.9 or T45.1X5A).
• A statement that hair loss is a side effect of treatment.
• The exact term “cranial prosthesis” — not “wig.”
• For cold capping: a statement that scalp cooling is used to reduce chemotherapy-induced alopecia.

This wording matters. When doctors use the correct medical terms, claims are more likely to be approved.

Step 3: Keep Every Receipt and Document

Your claim must include proof of what you purchased and what you paid. Make sure receipts are itemized and list the correct terms.

For a wig prosthesis, you need:

• An itemized receipt showing “cranial prosthesis.”
• The cost and date of purchase.
• The provider’s name and contact information.

For cold capping, you need:

• Invoices from your cold-cap provider (e.g., Penguin, Arctic, etc.).
• Dates of service — ideally one invoice per infusion.
• Proof of payment (credit card statement, receipt, etc.).

If your provider doesn’t automatically itemize “cranial prosthesis” or “scalp cooling therapy,” ask them to revise the receipt. It makes a big difference.

Step 4: Submit Your Claim (Here’s the Simple Version)

Most claims can be submitted online through your insurance portal. Follow these general steps:

• Log in to your insurance account.
• Select “Submit a Claim” or “Reimbursement Request.”
• Upload your prescription or letter of medical necessity.
• Upload itemized receipts and proof of payment.
• Use the correct billing codes if required.
• Include the provider’s information (wig studio, cold cap company, etc.).
• Double-check everything before submitting.

After submitting, save a PDF of your claim confirmation. You may need it if they request more documentation.

Step 5: If Your Claim Is Denied — Appeal

Claims are denied for many reasons that have nothing to do with eligibility. Missing wording, wrong codes, unclear receipts — all fixable.

If you receive a denial letter:

• Read the denial reason carefully.
• Gather any missing documentation.
• Ask your oncologist for updated wording if needed.
• Submit an appeal within the timeframe listed.

Many first claims are denied. Many appeals are approved. Don’t give up — this is your benefit, and you are entitled to advocate for it.

What Helps Most: Staying Organized

Submitting claims during cancer treatment can feel like climbing a mountain while exhausted. Organization helps — even if it’s as simple as a folder on your phone labeled “Insurance.”

• Save all receipts in one place.
• Take photos of documents as backups.
• Write down dates, names, and confirmation numbers.
• Ask a friend or caregiver to assist if you're overwhelmed.

You don’t have to do this alone — and you deserve every ounce of support available to you.

A Powerful Way to Receive Help During Treatment

Wigs and cold capping can be expensive, even with reimbursement. Many women feel uncomfortable asking for financial help — but your community wants to support you.

With Re-Femme, you can create a personalized cancer care registry where friends and family can contribute directly to your wig prosthesis, cold capping fund, recovery items, or anything else you need.

It takes the pressure off asking. It gives your village a place to show up. And it helps you feel held in a very real way.