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Scared - Having c4 to c6 fusion & ins. wants it to be outpatient

AnonymousUserAAnonymousUser Posts: 49,671
edited 06/11/2012 - 8:36 AM in Neck Pain: Cervical
I am scheduled for c4 thru c6 fusion surgery on October 16th. My doctor wants me to stay overnight and I just got a call from my insurance company (Blue Cross)that they consider the procedure to be outpatient. I am scared about having this procedure done and going home the same day. I spoke with my doctors nurse and she said he does all of these procedures at an inpatient. She said she will talk with him.

Anyone had this as an outpatient procedure? How did it go at home?


  • Outpatient fusion!! I don't know what to say!! I really hope that someday the policy makers at these insurance companies develop horrible back problems! Including CES! And definitely paralysis like I'm dealing with.
    I needed to go to rehab after my 15 days in hospital and 2 surgeries. My insurance company refused to pay. They said I didn't fit their criteria for rehab! They only approve it for elderly people or for people injured in a bad car accident!
    I sure hope your doctor is able to convince your insurance company to see the error of their ways! Good Luck! Please keep us all posted.
  • I had 2 level fusion done 6 days ago. Spent two night in the hospital. Could have handled getting released after the first night but was no where ready to go home same day.

    As someone who also works for a large health insurance company (not BCBS) I would appeal this decision through your surgeon as well as directly to BCBS.
  • I had a two level fusion using my bone and was admitted at 1pm on a Friday and released at 6am the next day. So it was less than the 24 hour period. It was in a surgery center and basically I was the only patient so had a private nurse for the night, who fell asleep. But actually I was ready to go home and felt more comfortable at home as well. I do hope you get at least that much time. The main reason is to watch your air way. I would appeal as well. Good luck and keep us posted.
  • I would also appeal this, I know people in NY who have called their local congressman or senator for help. But for sure I don't think you should do this as an outpatient. I had a C5-6 fusion 4 weeks ago and I was scedueled to stay 1 night, went into surgery 8AM and was in the SICU for the night, but because PT didn't think I was ready to go home stayed for 2 nights. Please arrange that you can stay for at least 1 night.

  • I had surgery at 7am and was on my way home at noon.
    Other than not having strong enough medicine, I was ok. Plus I had no neck collar...Good luck
  • never heard of it being outpatient. i was in hospital a little over 24 hrs. my insurance which is also blue cross (ny) approved for me to stay up to 5 days if needed. had same levels done. c4-6
  • I agree with everyone else. Most people that have had this done stay at least 24 hrs. You are having 2 level surgery so you would think you would stay as long or longer than me. I had a one level ACDF. Although mine was workmans comp they approved a one day stay subject to longer with a doctors request. Luckily I only stayed one day, I felt better to be home. Talk to your doctor and see if he can take care of this. If he requests you to stay longer most insurance companies should agree. Are you in the US. GOOD LUCK!!
  • I got a call back from the doctor's office and they are resubmitting the request due to risk of complications (something like that), but she did say if they decline it that I will be admitted as an outpatient, but I will be staying overnight. That is such a relief.

    I know everyones experience is different, but would like to hear your opinion on how the first week went with pain and being able to bend your neck that week?
  • I do not like the idea. I had a 2 level inpatient procedure in 2004 - c4-5 & c5-6 and was really in need of assistance for the 1st 24 - 48 hours. The insurance co. should be ashamed of themselves!
    Do you live with anyone who will be there for you 24/7?

    Anyone have similar surgery and then find 5 years later they are still in pain from radiculopathy or similar pain - neural or muscular resulting from waiting too long to actually have the surgery? I am. I'm considering the stimulator implant. Any concerns or exciting feedback on this?
  • I had a 2 level fusion on July 13, 2009. I went to an outpatient facility 1 1/2 hours from home, surgery at 8, and home by 1:30 that afternoon, no collar. I did fine, but I had my hubby, niece, and stepson to take care of me. I went to see the new Harry Potter movie the day after surgery (slept through it though). The surgeon had my pain controlled very well, and I bought a soft collar to remind me not to move my neck too much at the beginning.

    Every patient is different, as is every surgeon. I was lucky to be able to go home right away, when I woke up I was trying to get out of bed to get dressed LOL. If your surgeon feels you should be in overnight, then the insurance company should comply with his wishes. If they don't, they should appeal. The insurance companies are too powerful nowadays, they have the "standard of care" and very rarely deviate from it.

    I hope they reconsider and give you the inpatient time that you need!
  • tammie just wanted to let you know that I am going to have a one level C-4 ACDF and the surgeon told me I would go home the day after the surgery. So don't know what to say that seems awful quick. I have BCBS as well.
  • I was only in hospital overnite. be sure and take apillow for ur ride home mine was over 100 miles. the first week was terrible I ended up slepping on the couch.I needed to have alot of support even for my back and sleep with a pilllow between my leags be sure nd have alot of soft foods swallowing will be very difficult for about the first week. they went in through my front part of neck. now 4 months later still in pain looking for others also for advise good luck would be happy to answer amy question for u if i can
  • wow u felt alot better than me here
  • I got a call from the doctor's office and the insurance is not budging. They are approving me to stay for 23 hours and that is from the time I check (6:30 a.m.)but my surgery is at (9 a.m.). The doctor's office said they notified the hospital of the situation and they are to call the insurance company after the surgery to let them know that I am not able to go home and the insurance company will then they will pay. The doctor's office has only seen this happen one other time. Stupid insurance company.
  • Thats crazy.

    I hope that everything goes well and you get to go when you are ready.


  • I just had an ACDF C5/C6/C7(with bone spurs) on 09/21/09 as an outpatient. My surgery was scheduled at 7:00am and I was home by 1:00pm. I didn't have any problems. I was given plenty of meds. My only current complaint is that I am still having pain in my upper back and along my shoulder blades -- but I'm only 10 days post-op!

    At first, I was very surprised it was an outpatient surgery. But, then I was glad it was, because I was glad to be back home in my own bed!

    I wish you well.
  • My surgery got moved up to October 13th. I actually ended up staying two nights and not leaving until the third day in the evening.

    The surgery went well. I guess there was bone spurs to remove as well as the ACDF C4 thru C6. I was in alot of pain and they were having some problems with pain control which finally they got it under control with morphine (not sure whey they didn't just use that to begin with). The next day I had no appetite and my bowels were not making any noises (thats what the nurses say). The PT who came in said that I was not ready to leave the hospital and the RN that was taking care of me also said the same thing. So I stayed another night. They finally gave me solids on the third day.

    My throat was sore but not unbareable. I did seem to choke alot easier on food for the first week. But that is getting easier and my throat isn't sore anymore.

    I'm down to pain meds once in the morning and once at night with the occasional muscle relaxer and Tylenol.

    So far it was not as bad as I thought it would be.

    I have no clue how they figure this is an outpatient procedure.
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