Hello out there!!
Looking fo some advice,support.
I am 39 yr old female Mom of 2 teens and married x 18 yrs.
Occupation: Reg. Nurse currently on short term disability.
DX: DDD Lumbar; Herniation L3-4, L4-5 L5-S1 grade 5 tears
Mri,bone scan Discogram + at L3-4 and L5-S1 levels 6/09
Pain and one herniation started back in 1999 and since 2 further herniations.
Have tried conservative methods, Chiropractics,PT, Pain meds, tyl #3, percocet,Dilaudid,Flexeril,Epidural steroid inj x 5-6 over last 2 yrs.(last ones in 3/09 and 5/09)
Pain greatly intensified 1/09 especially with sitting. Low back pain L hip pain and bilat leg pain L>R. Great toes bilaterally get bad spasms,esp. with lying down.
Saw Neurosurgeon in 6/09 who ordered the bone scan and Discogram,spine xrays.
did more PT x 5 wks.
Scheduled for anterior lumbar discectomy L3-4 and L5-S1 with total disc arthroplasty Prodisc-L at L3-4 and fusion and L5-S1 with syn fix,BMP,bone graft in August '09.
The Neurosurgeon office called me Fri 7/17 stating my insurance company has denied the Art Disc stating "the procedure is experimental"
I have researched it a little on line and found that the FDA in the U.S approved Prodisc-L in Aug of 2006.
I am looking for advice on how to fight this without delaying my surgery in August.
I have called my insurance comp and initiated a "expedited appeal" and should hear back from an "appeals coordinator" in 72 hrs.
I have also asked my Neurosurgeons office MD or PA to do a "peer to peer " review with a MD at my insurance company.
I have already had Pre-ops done and have donated my first uniot of blood.
I have appt with Vascular Surgeon tomorrow and give my @nd
unit of blood this Friday.
Any help will be much appreciated!