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Cigna Insurance approval for Cervical Disc Replacement????

indetyna531iindetyna531 Posts: 2
edited 06/11/2012 - 8:30 AM in Neck Pain: Cervical
~X( X( Today is my 1 year anniversary of having a Herniated C5-6 disc that needs surgery. I cannot get Cigna to approve the recommended surger for Disc Replacement. I am in agony everyday and the nueropahty is only getting worse and worse, and has recently started affecting my legs and feet. Has anyone had any success getting the losers at Cigna to approve this surgery?????


  • From what I have heard, cigna and aetna cover ADR . Have you read their policy statement. These insurance co's will often deny ADR even though their policy shows they cover it. They just hope you go away and don't catch the discrepancy. Buy laurie Todd's book the insurance warrior. She outlines how to win your appeal.
  • I'm scheduled for surgery in a couple days and Cigna pre-approved my surgery for C5-6 already. I received an approval letter that they approved a "spinal fixation device". Hope that helps. I have had PT and 4 epidural nerve block injection prior to being approved for surgery.
  • 2000- Start of off and on back pain.
    4/08 - MRI shows portruding disc at C6/C7, slightly
    bulging disc at at C5/6. DDD present at both levels.
    5/08 - Had c6/C7 epidural injections, significant but
    temporary relief.
    6/08 -Discogram painful at C6/7 , C5/6 not painful
    but pop rock type noises occurred upon disc
    7/08- Had Plasma disc decompression for C5/6 & C6/7-
    Very Significant pain reduction achieved.MRI shows
    portrusion gone.
    10/08- Pain starting to come back
    12/08 - Pain almost as bad as pre surgery again. Getting grinding noises for the first time. Cant sleep without Hydrcordone and alleve.Currently looking into ADR with Tx Back Inst but being told I might not be a candidate for surgery with them due to failing their Psyche tests.
    1/09 -My doc at the Tx back inst cleared me past the psyche issues (I dont think his psychologist was too happy about that-wont explain why here). Discogram shows 2 levels causing pain. BUt I decided to go the cheaper route and to go with one of the best multi level adr surgeons IN THE WORLD,Dr B. in Bogen , Germany. Dr B. has performed 3000 ADR surgeries so far!
    2/26/09- 3 level ADR Surgery with Dr B. (Interop it was determined that I needed 3 levels as the 3rd suspect disc was leaking dye into the spinal channel).
    SUCCESS!! All the old deep pain is gone!!
    5/18/09- X ray shows that my top plate of my C6/7 proDisc is s sinking causing subsidence of the bottom plate. Fusion recommended at this level now.
    9/22/09- Revision surgery with Dr B. in Wisconsin to have all 3 ADR's removed and converted to 3 level fusion due to staph infection in the ADR's. Apparently, ADR's(or any implants) usually have to be removed if a infection parks itself on them. Two weeks post op pain free and doing well so far.I just hope that I fuse at all 3 levels.

    Your story sounds scary and I am wondering how you are doing now? I have C5/6 and 6/7 herniated also with a 3rd starting to herniate also. I have been in excruciating pain these last few months. I have been told by 15 Dr.'s not to have fusion surgery because I am only 35 and it will affect me worse down the road. Cigna won't pay for a 2 level fusion because it's considered experimental so I am at a horrible crossroad of what to do. I am thinking of getting a lawyer to fight them, but then I hear stories like yours and it makes me terrified to do any surgery! How are you feeling now with a 3 level fusion? I know it is fairly recent, but that is a lot of discs to have fused! I am scared I will end up in the same position and be in worse condition the rest of my life. I don't know what to do, but I'm desperate.
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