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Old 01-03-2009, 06:04 PM
Nairek Nairek is offline
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Join Date: Apr 2005
Posts: 148
Default Surgery Date Set, But Will Insurance Pay?

So, after having an SI joint injection and a 3rd, yes a 3rd discogram, I have made a decision with regard to surgery.

The SI joint injection was a diagnostic injection of numbing medication & was only about 20% effective in relieving my pain. It's a good thing the pain mgmt. dr. had good reflexes. Poor guy was close to getting punched out when he pressed on the SI joint after the injection.

My 3rd & most painful discogram, it was positive at L5/S1. I told the OS that my last 2 were positive at the same level but he wanted "his guy" to do it.

I have steadily spiraled downward with my back since the summer. The last discogram has left me in constant discomfort with more pain than I am use to.

I am scheduled for surgery on January 20th in NYC. The type of surgery will depend on the facet block that I will have on Monday. I want a disc replacement but as I understand it, if the facet joints are causing the pain, I would have to have fusion.

Now the interesting part. I am waiting for his office staff to get me pre-certified through No-Fault and my private insurance. I was assured by his staff that the hospital will not allow the surgery to go forward if I don't have the pre-certification.

Talk about being on edge..... This should be an interesting few weeks. I know it's a little too soon, but the reality of it is starting to hit me.

I'm keeping my fingers crossed & hoping that things will work out for me this time. I don't know if I can go another round with the NYS Dept. of Insurance.
__________________
----Karin----
Disc Bulge C4/C5, Disc Degeneration T11/T12, Bi-Lateral tears L5/S1, Diagnosed w/ Lumbar Disc Derangement w/ Radiculopaphy. Treatment: IDET, Percutaneous Discectomy, SI Joint Injection, Facet Block. All failed. Empire BC/BS Denied Coverage for ADR-lost all of my appeals. MVP also denied coverage.

ALIF/PLIF Fusion 1/20/09
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