Jerry,

I know this is all nonsensical. US insurance should just pay up! They ONLY paid 1/3 of my total bill so why the big tantrum! ?

My right foot and big toe are very numb and painful . I have a nerve root blockage at L5. i don't know when I am going to get that fixed as I am still on the mend from my last ADR surgery. I am a slow healer. It seems as most men on this board heal quickly!

Good luck to you . Keep me posted!:clap:

Tammi

Tammi,

Sorry to hear about the foot and the big toe.

I have residual as well, most of the sensation in the right upper leg is gone.

The pressure is off the immediate part in the back, from the L2-L3, but there is still pain radiating from this area, as well as the 4-5 and 5-1 area in my back and radiates down and out.

(People do not understand this, I ask them, have you had a very sharp pain from a splinter, in your finger, now put a half dozen in your back, and it does not go away)

It hurts to sit, (have a ball chair at home, and a modified ergo chair at work) I went out to eat, and did something, sitting in a chair, and spent several hours on Sunday on my back.

This is what I am trying to prevent, an ounce of prevention is better than a pound of cure.

Just pay for the ADR.


I will have some testing, guess they hit the areas in the back and try to indicate where the pain is coming from, as if I don't know.

Not sure about healing rates, some people heal very quickly.

Jerry

Jerry,

I had two level ADR, m6 disc done in Barcelona, oct. 24, 2012. BCBS paid 60%. I do not know why they paid, but they did. I know many others say that BCBS will not pay for a 2 level ADR, especially for a device that is considered experimental in the US. However, the procedure IS NOT experimental in Europe where I had the surgery performed, which we pointed out to BCBS when we filed the claim. Also, Hospital Quirón is on the approved list on my BCBS rider.

Good luck, I hope you get them to cover your procedure. I think we all need to push insurance companies into accepting this procedure works & in the long run saves money and helps people feel better.v we also need to push the FDA to approve the M6.

Two Level
 

You said you had two level, what levels, and if they are not adjacent is this considered two level, meaning, adjoining.

I really need three, if I am going to do this right.

Have the damaged disc, L2-L3 done at the same time as L4-L5 and L5-S1.

L2-L3, has to be done from the side, or there is a different procedure for that level.

The 27th, I will have another test, not discogram, but electrical stimulus, I guess it hurts, but not like the discogram.

This is really sad, that the FDA is dragging it's feet, there is no reason they would not allow this to move forward, so people can move on with their lives.

BCBS Ohio, is one of the worst, and I have talked to several people, they are going to be dropped.

Most likely, I will drop them next year.

Will post the results of the tests later.

Thank you for sharing your information.

Jerry

Jerry

I had two levels. C5-6 & 6-7 there was some question about 3-4 and I may have to consider that in the future, but have to symptoms and hold high hope that I never need to. BCNS paid 60%.
Best of luck, hope you get them to pay.

Update.
 

2 confused and Tammi,

Just had another consult with an interventional pain Dr.
Have to jump through the ropes.

He will do nerve blocks on the L2-3, L4-5 and L5-S1 levels on the right side in about a week, then after awhile, another couple of weeks, do the left side, same levels, then I have to endure the discogram.

This will happen in the middle of September, why not just do the discogram, get it over with and move on.

This is truly insurance hell, I also have the option of getting some help from the VA, so I am going to use both of them, not sure how this will work, but fusing, rods and plates are OBSOLETE, as long as they have the advances they have now.

The M6 seems to be the best, from what I have read.

If they do not allow a two level, (I am not sure I need an ADR at L4-5, but for sure at L5-S1), and the damaged disc at L2-3.

So this would be a two level but not at adjoining discs.

In the meantime, I take some Codone, which makes me sick sometimes and my stomach sore.

Not sure what else to say, just keep banging away at this insurance (I don't see how BCBS stays in business?).

All for Now,

Jerry

Update
 

Sent the Information to German Spine Specialists, and they came back with the three level, L2-3, (Nuvasive-Lateral) and the L45 and L5S1, I have submitted this on 10/23 2013, no word so far.

I do have BCBS, and Hoping the VA will go along as well, they (VA) are part of the USA medical system, so most likely, they along with the private insurance will say this is investigational.

The M6L is NOT investigational in Europe, and at least one Dr, Bierstedt, has done over a 1,000 of these procedures, and the outcome many years later is good to Excellent.

There is NO reason the USA (FDA) should not approve this medical device, NONE.

Jerry

By the time the U.S. let's us have the M6, it will be the M7! :laugh:

So a 3-level...are all levels with a Nuvasive? I'm not that familiar w/the lumbar procedures. Sounds fascinating-tell us more about if you don't mind.

Nuvasive
 

Jen,
They use some neuro stimulation, if I remember reading this right, so they can tell where the nerves are, that come from the back, toward the front, along the ribs, they can see where these are, and make an incision, between them, off to the side, laterally, just in front of the ribs, about 4 or 5 inches above the belly button, they dont cut anymore, from what I have read, they separate, sort of like tear, the muscle, it heals better that way, and then use the hands to move the organs, much better, and less destructive, the lower levels, they just come in the front.

Nuvasive is described on the German Spine Specialists website.

Your right, once they approve this in the USA, it will be the M7, or 8, silly.

Go to that site, do searches, there is a lot of information available.

Jerry