In reviewing the fee updates for Az BC/BS, I noticed that lumbar ADR is listed with a procedure code. So, at least for some contracts, Arizona Blue Cross/Blue Shield is covering this.
Hope this info helps in the insurance fight.

That's interesting and wonderful news! Thanks for sharing this (surprising) news.

On the flip side of this is the actual reimbursement amount provided to doctors' offices. I've heard from doctor's office managers that the reimbursement for the ADR procedure is $1400, vs. almost $10,000 for fusion. If this is true, then there could be (or there already is) all kinds of consequences for the patient community. http://adrsupport.org/groupee_common...n_rolleyes.gif

so your stating teh reason doctor haven't jumped on the ADR bandwagon is cause they aren't getting paid their fair share?

This would help explain why ADR has just begun to hit US shores

Zorro, I don't know what the implications might be for the reimbursement; I think the whole situation is complicated. My hope is that the difference in reimbursements (ADR vs. fusion) will not bias the decision(s) of all parties involved -- but I think that's idealistic!

If anyone else insights or comments, please share them. http://adrsupport.org/groupee_common...n_confused.gif

I have serious doubts that there is such a great disparity in fees for the 2 procedures. Procedure codes allow billing for arthroplasty/arthrodesis, with additional billing for instrumentation; there are probably other procedures involved in the surgery that are billed separately. Fusion may involve bone harvesting and grafting and perhaps may therefore have a higher total fee. I don't know the specifics but I do know that the fees listed for arthrodesis for BC/BS are not $10,000--but the total for all procedures involved in the surgery may approach that. Again, I doubt that the total fees for all procedures involved in ADR are that much less.