Ok, I am in the later part of a flare up. You all know that I have said when a flare up lasts more than 3 weeks, its time to see a doctor. I did, they did X-rays and such, and came up with the diagnosis: Acute Bursitis of the Hip Joint
Thing is, I know this doctor very well, and as my wife and I were talking with him, he was going through the various ICD-10 diagnostic codes. The way insurance works today, your problem needs to fit into one of those codes. It is beneficial to both parties. The doctor's practice will get reimbursed and as the patient, you should get the necessary treatments without additional screening.
Problem is, my problem is beyond what the ICD-10 codes allow. The doctor knows it, but unfortunately, he can not do anything about that. He did go beyond the guidelines and prescribed a medrol pack that may help ( really didnt it)
In reality, 10 years ago, based on my clinical examinations, additional actions could have been put in place for me. But today, its impossible, unless I fit into one of those codes, the doctor is very limited. Sure, he can go and provide all sorts of treatments, but when the insurance company reviews it, they decide if its going to be approved or not.
Its frustrating for everyone. I can not get what I probably could use, the doctor can not prescribe what he believe should be done.
I do know right now, one of our better more educated member, Itsautonomic, (Aaron) will add some of his views on this. Anyone who has been dealing with this for years understands the ins/outs the problems, the good and the bad.
Meanwhile, I am having trouble walking using ice every nigth tens unit 3x day and nothing is really helping (at this point). I do know that in time, this will pass, as all flare ups do, but geez, I would love to have these flare ups go away quicker.
Sorry, for my rant... I guess I can get negative as all of us can at times.
Ron DiLauro Spine-Health System Administrator I am not a medical professional. I comment on personal experiences