[luckyshot]

I need help, advice, or anything some of you might offer.

been having back pain progressively worse for the last 3 years. I have to fix it now and I want my active lifestyle back. I was sent from the neurosurgeons in KY to Cleveland Clinic. I was then told that I needed surgical intervention at L4 L5 and L5 S1.

Dr. McLain in Cleveland told me about the difference in ADR vs fusion. I immediately decided to have ADR at both levels. But, he said my insurance would not pay for it, they might would pay for a hybrid. I am determined to get both levels fixed with ADR. He didn't even submit the CPT codes to Aetna. Instead I drove 400 miles back home and his office called and told me that this particular CPT code for a two level ADR does not exist. I am no doctor, but from what I've come up with 22857+0163T should do the trick. If they don't even know what to ask the insurance company for, I sure don't want them doing the operation anyway.

Going overseas for me and paying out of pocket is out of the question. My Aetna policy states that it pays for nothing elective outside the US.

I've been sent home from a very physical job because they have no "light duty" light enough per my doctors specs. So, I have about 5 more weeks short term disability before I go unpaid.

I contacted Texas Back Institute by voice mail and by e-mail and have had no response for two weeks now.

Possibilities?
-a doctor in the US who might do a two level ADR within Aetna's network,
-a letter of commitment to pay overseas from Aetna,
-precedents or some documentation of Aetna covering 2 levels in the US.

I really don't know what I need or where to go. I've got MRI, Xray, and CT scans, as well as all the radiology reports that go with them, on hand and ready to ship. I never even had a Primary Care Physician until all this started a couple months ago. ANY advice will be appreciated.

Thanks so much.
luckyshot