Anthem Blue Cross Denial of Lumbar Fusion
Hi Fred:
Blue Cross reply to me when denied and when I spoke with them was simply " determined your request for service is not medically necessary". They will not offer any option, simply a total denial of service for fusion of the bi-lateral decompression of L1,L2 and L2,L3 plus a laminectomy of L3, and L4.
I have been diagnosed by several doctors with moderate to severe DDD at several levels, moderate to severe bi-lateral and central canal stenosis on several levels, have 24/7 numbness and tingling along with weakness and of both feet and legs, severe lower back pain and recent onset of some incontinence. The numbness and incontinence alone should quality as a medical emergency, but Blue Cross has taken the stand that despite the doctors reports, MRI's, epidurals, pain medications and pain management, etc., there is no "medical necessity" to allow me treatment.
If they can do this to me, they can do it to anyone.
Gwin
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