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Insurance Hell All insurance-related matters are here: Medicare, worker's compensation, appeals, denials, insights, wins, losses. PRICING is here too. Note: This forum has posts from 2006 forward. Older ones are in the Big File. |
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#11
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For those who feel strongly 2 level TDR is what they need... remember FDA approval shouldn't be far off if you can wait (within one year). I agree totally with ans about considering hybrid; many doctors and some of us individuals actually find it preferable for L4-5 TDR and L5-S1 fusion. (It turned out in my husband's case that L4-5 could have a well seated and placed TDR, but the L5-S1 level skews just enough, which apparently isn't unusual, that a TDR wouldn't be perfectly aligned... not fully visible until exposed by surgery.) There's the consideration that for most people L5-S1 has very little movement naturally.
ans: You know you can make this happen. Get a few doctor consults from docs you trust and go for it... there's a lot of data out there now that makes hybrid a much more winnable fight. (I'll be glad to share the particular studies used to convince CMS, but I'd guess most docs can get a pre approval in their own way.) The biggest issue if docs consulted find you an 'appropriate candidate' given your specific back condition. For that, I'd see at least 2 docs you really have reason to trust. Debi
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---------------------- Deborah C3-5 fused 2001 Hub: C3/4 fused 2001 Hub: TDR Prodisc L4/5, Fusion L5/S1 on 3/3/2009 |
#12
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Thank you very much Debi. My best to hubby. - Allan
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Severe, extensive DDD, considered inoperable by Dr. Regan, Lauressen, & some guy at UCLA. Severe foraminal stenosis (guess they can't operate!) and some spinal cord compression that Lauryssen would fix if gets outta hand. |
#13
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Kaiser LA/Orange county DOES do ADR cervical and lumbar
Hello I am a patient of Kaiser also and just had a one level ADR L5/S1 PRODISC. I have my surgery in Baldwin Park at the spine center so I dont know if every county covers them or not. My surgeon was Dr. Tang, Chris. I also know they use different disc's for the replacements I just dont know all of them. I do know that the charite one was recalled by kaiser and they will no longer implant them for whatever reason they have. I also know that kaiser now has a lot of different coverage plans and depending on the plan patients have will determine hosptial co-pays, deductibles ect. So although kaiser does implant cervical and lumbar ADR at least in LA/Orange county Iam not 100% they cover everyone or every county or state. I hope this helps!
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Car accident 03' T-Boned on my driver side Chiropractic, P.T 03'-06' MRI Lumbar- 07' 8mm herniation L5/S1, DDD,spinal stenosis 2 Epidurals, 2 SI Joint injections, Facet Injections Discogram 6/08' positive herniation and annular tear IDET 8/08'- NO SUCCESS Functional Discogram 1/09' positive for pain in only that disc L5/S1 Lumbar x-ray 2/09- severe DDD PRODISC ADR L5/S1 4/09- over 80% improved!! |
#14
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Thank you J. Best of luck to you. - Allan
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Severe, extensive DDD, considered inoperable by Dr. Regan, Lauressen, & some guy at UCLA. Severe foraminal stenosis (guess they can't operate!) and some spinal cord compression that Lauryssen would fix if gets outta hand. |
#15
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Thank you!!
Thank you ANS. I had a great experiance with kaiser, If anyone has any questions, Iam more than happy to answer them..
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Car accident 03' T-Boned on my driver side Chiropractic, P.T 03'-06' MRI Lumbar- 07' 8mm herniation L5/S1, DDD,spinal stenosis 2 Epidurals, 2 SI Joint injections, Facet Injections Discogram 6/08' positive herniation and annular tear IDET 8/08'- NO SUCCESS Functional Discogram 1/09' positive for pain in only that disc L5/S1 Lumbar x-ray 2/09- severe DDD PRODISC ADR L5/S1 4/09- over 80% improved!! |
#16
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I don't know where you are but I do know that Kaiser Oakland does them. They would have done mine but for my slightly arthritic facet joints and suggested a fusion instead which I ended up doing at Stanford.
The surgeon seemed very knowledgeable and spent an over an hour with us. I'm blocking on the the surgeon's name but it started with a G. Gorek?
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Minimal DDD L4/L5 Minimal DDD L5/S1 Disco 4/07 : Large tear: @L5/S1 Idet 4/08 No improvement Now looking at ADR vs. Fusion ALIF Fusion 2/10 Stanford |
#17
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Thanks
Dear Kaiser Members,
J: I'm amazed that they approved a ProDisc at this level. I hope that you are faring well. Duh, was your surgeon well-trained in ADRs or different fusion techniques? Does a member have a choice of surgeons at all? I'm a bit leery b/c I've been told that there's little choice w/Kaiser. Appreciate your time. Best - Allan
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Severe, extensive DDD, considered inoperable by Dr. Regan, Lauressen, & some guy at UCLA. Severe foraminal stenosis (guess they can't operate!) and some spinal cord compression that Lauryssen would fix if gets outta hand. |
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