I have a CT scan next week at the Cleveland Clinic. They are great doctors but I am concerned they don’t have enough experience with ES. I am looking into Dr. Cognetti in PA. Does anyone have experience with him trying to set up an online appointment? I’d rather not have to go to him for a visit.
Dr. Osborne in LA has a virtual option that I may try. It’s just a long way to travel for the surgery. But he does seem to have a lot of experience and good success rate.
Thanks for your help!
Both doctors are excellent! We’ve heard that Dr Osborne’s costs for surgery are pretty high, I can’t remember the situation about whether he will take insurance, there have been a few discussions about this. Dr Cognetti charges less, & definitely does telehealth appointments , quite a few of our Canadian members have seen him for surgery.
Otherwise one of our members has commented on Dr Lamarre, @Newmadison1 & how impressed she was with him in this discussion, he’d be nearer to home:
Surgery date soon - Support - Living with Eagle
Hopefully others can give you advice about setting up an appointment with Dr Cognetti if you decide to do that!
We have more members who’ve had ES surgery done by Dr. Cognetti than w/ Dr. Osborne, but in fairness, Dr. Cognetti’s name has been on our Doctors List since 2014 or earlier, & Dr. Osborne was only added about 5 years ago. As @Jules said, both are excellent surgeons. Both do telehealth initial visits so no need to travel, & I believe both require you to send in your CT scan images to be reviewed before they’ll make an appointment for an initial consult, but that might be an old protocol as many offices now don’t want the CT images until an appointment has been made. You’ll need to contact the office(s) of whomever you choose to see to ask about that. We do recommend getting a couple of opinions i.e. having a couple of consults if your insurance will help pay for them.
If you contact your insurance co. & ask about coverage for ES, you’ll likely be told they don’t have a billing code for that so it’s not covered even though we’ve heard an ICD-9 code has recently been added for ES. My doctor billed my styloidectomies as mini-craniectomies or just, craniectomies which, in fact, is what a styloidectomy is, & my insurance covered its share of my surgery w/o question.
@Jules - thanks for the recommendation about Dr. Lamarre! After I get my CT I’ll ask about him. I’d like to keep it close to home if possible and the Cleveland Clinic has been really great to work with.
@Isaiah_40_31 - when I called Dr. Osborne, they said they normally don’t accept insurance. My church uses medical sharing (Christian Healthcare Ministries). Dr. Osborne’s office said a few of their patients use medical sharing as well and they use the following CPT code for the surgery: 214.99. They have the diagnosis code M24.20 and the medical sharing companies have been accepting that and share the surgery.
Thank you for that information, @paul15. Several families at the church I attend also use medical sharing Christian Healthcare plans & have been very happy with them.
I hope Dr. Lamarre works out for you. 
I appreciate the CPT code information. Thank you for posting it for us.
I have CHM (Christian Health Ministries) as my backup “insurance”. I know they have some exclusions related to jaw, tmj, etc.
Did you contact them and ask if they cover that procedure code? It is my understanding that if you ask for it to be shared with others for extra giving it still has to meet their requirements.
@JugularEagle I’ll have to call CHM with codes. I would hope they’d cover it. I’ll let you know what they say.
Here is the relevant exclusion (might be a gray area):
“MAXILLOFACIAL EXPENSES—expenses from temporomandibular joint disorders (TMJ/
TMD) and similar dental-related conditions, including but not limited to malocclusion,
micrognathia, and congenital malformations of the jaw, are not eligible for sharing. This
exclusion applies regardless of variations in diagnostic terminology or coding, the location
where the treatment is rendered, or the type of practitioner providing treatment (i.e., DDS,
DMD, or other).”
@JugularEagle - ES doesn’t fall into any of the categories mentioned in the Maxillofacial Expenses. It’s related to the skull base not the jaw. Mine was billed as a craniectomy though I understand via some of our members that there is actually a billing code for ES now. We’re making progress!!
That is good to hear about CHM. It opens up my options.
@paul15, I asked the oral surgeon about the splint issue. I think that is a good way to characterize it. It was an interesting visit. The Dr was nice but he sure didn’t want to touch talking about Eagle Syndrome with a ten foot pole as they say.
Kept saying it was an ENT issue and would reference what the neuroradiologist said which actually contradicted the ENT.
Anyway, he gave me a sheet with different things to address. One of them is a habitual training technique to deal with the mouth issue. You put a bright sticker on surfaces in areas that you frequent such as refrigerator door handle. When you see it you think “What is my mouth doing right now?” Such as clenched teeth or tongue jutting forward, etc. You correct it every time you see the sticker. I am going to give it a try.
He said a lot of my pain is myofascial and sent me to physical therapy. I have already done that which aggravated my situation before we knew the issue. I am going to try it again but this time not do some of the things that triggered me like the rearing your head back. I am convinced that caused a cervicogenic type headache that I have never had in my life where I thought I was having a stroke. Also mentioned dry needling.
It might help some people to look up various habit reversal techniques.
Our member vdm posted quite a bit about the effects of poor posture & other habits we develop that can cause symptoms to increase or escalate. You can search for his posts, but here are a couple of links to get you started.