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Keith Denkler, M.D.


Contact Info


 CONTACT INFO



Kybella


Common Procedures


BOTOX® for Wrinkles


 Dupuytren's Disease



Dupuytren's and XIAFLEX Pictures


Dupuytren's Contracture (Maladie de Dupuytren)


Dupuytren's for Patients


FAQ/Needle Aponeurotomy


XIAFLEX for Distal Joint Dupuytren's Contracture


ASSH Hand Society Presentation of NA


AAPS Presentation on Needle Aponeurotomy for Severe Dupuytren's


Dupuytren's Boutonniere Deformity Treated with XIAFLEX


XIAFLEX Boutonniere Treatment


2011 ASSH Dupuytren's Needle Presentation


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Credentials


Curriculum Vitae


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 Needle Release for Beauty



Needle Release for Beauty

Keith Denkler M.D.  
415-924-6010  
275 Magnolia Ave.  
www.PlasticSurgerySF.com  
Larkspur, CA 94939  


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FAQ/

Will insurance cover NA (Needle Aponeurtomy for Dupuytren's)

Insurance companies vary considerably in their approach to NA.  Straight Medicare covers 80% of ithe fees.  Coinsurance picks up some or most of the rest.  Medicare requires the doctor to purchase the drug and bill Medicare first.  Private insurance plans , HMO's, and Medicare Advantage plans have their own rules. That is why it is important to phone 1-877-XIAFLEX (1-877-942-3539). This service will help you sort out your insurance options.  While HMO's cover the open surgical approach (fasciectomy for Dupuytrens) they may consider NA experimental, and they may want their physicians to do all the injections.  Private insurance companies vary in their coverage.  You can call them and see if they cover CPT code 26040 (needle fasciotomy) for Dupuyten's, or the enzyme alternative, XIAFLEX, and for how much per finger.  The diagnosis code for Dupuyten contracture is 728.6.

How much does NA cost?

The initial consultation fee is 145 dollars.  The cost of the first finger for NA is 995 dollars, and each subsequent finger is 450 dollars.  There are no hospitalization or anesthesiologist costs.  Patients with more severe disease may need follow-up hand therapy and custom splinting at an additional cost.  Follow-up night splints may be purchased at an orthopedic supply or online such as the FIXXGLOVE

Link:

http://www.danmicglobal.com/fixxglovepalmarorthosis.aspx

Does Dupuytren's recur after NA?

 

Dupuytren's disease returns after all treatments including, NA, XIAFLEX, and surgery.  It is more likely to return after NA since the no Dupuytren's is removed.  Needle aponeurotomy only separates and pierces the tissue, so the tissue may reconnect and the finger will recontract.  However, recurrent disease after open surgery is difficult to retreat. Performing a second NA is much like the first one.  Some patients gain improvement for years after NA, but most will need re-treatment wihtin five years.



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Keith Denkler, M.D.  |  Contact Info  |  Kybella  |  Common Procedures  |  BOTOX® for Wrinkles  |  Dupuytren's and XIAFLEX Pictures  |  Dupuytren's Contracture (Maladie de Dupuytren)  |  Dupuytren's for Patients  |  FAQ/Needle Aponeurotomy  |  XIAFLEX for Distal Joint Dupuytren's Contracture  |  ASSH Hand Society Presentation of NA  |  AAPS Presentation on Needle Aponeurotomy for Severe Dupuytren's  |  Dupuytren's Boutonniere Deformity Treated with XIAFLEX  |  XIAFLEX Boutonniere Treatment  |  2011 ASSH Dupuytren's Needle Presentation  |  Credentials  |  Curriculum Vitae  |  Directions/Office Hours  |  Links  |  News Articles  |  Needle Release for Beauty

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