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Insurance Coverage for Sacroiliac Joint Fusion



  • SavageSavage United StatesPosts: 7,385
    Hello judyedd!

    Welcome to Spine-Health
    Please click on link for helpful information!
    Honorary Spine-Health Moderator
    Please read my medical history at: Medical History

  • I have Anthem  BC/BS and am needing a bilateral SI joint fusion along with an l5-s1 fusion, which was of course denied. My surgeon appealed, and that of course was also denied. My next recourse is to file a 2nd level appeal and also call my state's department of insurance. I used to work for them so I may just call them to see what they can do, if anything. The one thing that stood out on the letter that I received was that an internal medicine doctor reviewed the appeal and denied it. It wasn't even a surgeon for goodness sakes. 

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  • Read through this thread dated back a few years and I am in the same boat now. I’m looking for resolutions to the insurance companies not approving SI Joint fusion because they are investigational. I have capital blue and I’m desperate for surgery. Any updated advice?

  • LizLiz Posts: 9,658

    This is an old discussion created by a member no longer on the forum so I have to close it.

    Liz, Spine-health Moderator

    Spinal stenosis since 1995
    Lumber decompression surgery S1 L5-L3[1996]
    Cervical stenosis, so far avoided surgery
This discussion has been closed.
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