New BCBS Policy on Fusion

[Harrison]

Please see attached, and read the exclusion criteria carefully (when lumbar fusion is not covered, page 3.)

[Harrison]

When Lumbar Spine Fusion Surgery is not covered

BCBSNC will not provide coverage for lumbar spine arthrodesis (fusion) surgery when it is considered not medically necessary.

1. Lumbar spine arthrodesis (fusion) surgery is considered not medically unless one of the above conditions is met.

2. Lumbar spinal fusion is also considered not medically necessary if the sole indication is anyone or more of the following conditions:

> Disk Herniation
> Degenerative Disk Disease
> Initial diskectomy/laminectomy for neural structure decompression
> Facet Syndrome

So when the hell is it possibly indicated?!

It would appear that this insurer is making less and less treatments available for people suffering with severe spine pain. So what new options are they providing patients? I don't get it; this seems like cruel and unusual punishment.

[Tatonka_usn]

Wonderful! It's not like most folks even WANT to be fused, but now even THAT is becoming less of an option in the interest of preserving corporate profit. Maybe we should just send them our vertebrae as a downpayment??