[thumoeides]

I am not sure how to measure the extent of herniation. If I understand the question rightly, the MRI report speaks of a C6-C7 left foraminal disk protrusion, which as I understand is better than an extrusion. The CT scan report of a left foraminal herniated disc with some extension below the disc line without specifiying whether it is a protrusion or extrusion.

At C5-C6 there is disc degeneration with a loss of disc height, posterior disc bulging and mild to moderate central canal stenosis as well as moderate bilateral neural foraminal stenosis. But there appear to be no symptoms from that.

I have left arm and shoulder radicular pain which varies because if I keep my head bent down I can relieve the pressure on the nerve and thus the pain. I also have significant muscle atrophy and weakness of the left pectoral muscle, the triceps and the wrist extensor. All that seems to be caused by the herniation at C6-C7.

I would appreciate any help in getting BCBS to make a decision.

What does it mean to argue within the terms of medical necessity? Can that even be done prior to getting a decision from the insurance company?

I was told by the woman who prepared the predetermination letter--she works for Therapy Solutions which is hired by Prestige to handle these things--that BCBS will not be influenced to move more quickly by anything less than life threatening problems.