[NJ Gene]

Dear Luckyshot,

Texas Back Institute, besides being one of the best institutions in the U.S. for ADR, is known to also be one of the best ones in assisting patients with insurance appeals. I think you need to be persistent (ask for the main operator to transfer you to Dr Jack Zigler's office) and insist on speaking with a live person. I have no doubt that they will know the insurance codes. It's only been a recent development where the FDA has allowed 2-level fusion in the U.S. Many insurance policies will still consider it "experimental" and will not cover it. Also know that a hybrid is not necessarily a bad thing (much better than a 2-level fusion from what I've heard). I had a fusion in my lumbar spine at L5/S1 three years ago and I feel great (with respect to the lumbar spine). If you look at my signature, I don't even mention this because most of my issues have been cervical.

BTW, it's highly unlikely that your policy will cover anything if you go overseas. The only people who have some luck with overseas coverage are those with a Blue Cross/Blue Shield international plan. Furthermore, they generally don't get pre-approval. Those that go overseas usually have been in severe pain for a very long time and are prepared to spend a minimum of $30k to $40k out-of-pocket with little to no expectation of reimbursement. Don't get me wrong, most people who have gone overseas have had excellent results. However, it does come with a price. Every cloud has a silver lining though. To the extent that your medical costs exceed 10% of your adjusted gross income, they can be taken as a deduction on schedule A of your tax return (regardless of whether of your expenditures are in the U.S. or abroad).

If you need further information, don't hesitate to ask.

Good luck!!

Gene