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Radicuopathy vs diabetic neuropathy how to diagnose?

MaggiePMMaggieP Posts: 349
I am having trouble getting my insurance company to approve an MRI of my Lumbar spine. In April, I had Cervical and Thoracic MRI'S. They showed DDD, osteophytes, stenosis, bulging disks. My neuro, who did the physical exam, said my leg pain and weakness was from the Cervical C3-4 with nerve root impingment, and diabetic neuropathy. He perscribed Lyrica, which isn't helping a whole lot. Now my PCP wants a Lumbar MRI, to see if the L4-5 bulging disk has worsened, or if I have Lumbar stenosis. My insurance company turned down the request for pre-approval today. Without these lower MRI's, how can a doctor make an educated diagnosis of what is causing my pain and lower extremity weakness. I think the Insurance Company, who recommended PT, just doesn't want to cover me. How can they want PT, if we don't know the cause of the problem? The treatment is different depending on the diagnosis, right? And does Lyrica help with Radiculopathy? I'm confused!!! Help please! And to boot, leaving on vacation after work tomorrow after work, trying to get ready, now this to deal with! I quit! I resign from this shi*!


  • You are exactly correct in your requests. It is possible to have both radiculopathy and other types of neuropathies. The two can feed off of each other. Or there can be one.

    I'm in a similar type situation, where I have radiculopathy and burning feet. (They also turn bright red and swell) It turns out the burning feet is either from the radiculopathy or small fiber neuropathy in my feet.

    Has your neuro performed EMG/Nerve Conduction Studies on your lower extremities?

    If he hasn't request that he performs these tests.

    Also, you should have your doctor write a letter of medical necessity to your insurance company. Have the doctor send a copy to you too.

    Then, your part is to complain to your local state board of insurance.
    Write your complaint and also send them a copy of the doctor's letter of medical necessity.

    Then, send a copy of the complaint letter to your insurance company. (This will speed up the whole process)

    The state board of insurance will investigate your complaint.

    Everytime I've complained to the state board, my insurance company usually does a 180.

  • Wow, thanks, good idea! This insurance company calls itself the Wal-Mart of insurance companys. Cheap for employers.....but now us employees are finding out why. Hardly any preferred providers in our small town. They are supposed to cover things like massages, but have no-one in our area that are acceptable to this insurance do. I know they don't like me, and would probably be very happy to see me go away. Most of our employees are young to mid-40's. At 61, (on Aug 3) I have a lot more medical issues than the average imployee to deal with. Tough on them. They don't cover much on our perscripts either, a month of Lyrica costs me $75.00, and had to fight for over 2 months to get it approved. Just finished packing, and am going to Cheyennd Frontier Days, and forget all about this for the next week! Will start fight for approval when I get back.
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