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Old 11-06-2014, 04:46 PM
1Day 1Day is offline
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Join Date: Oct 2013
Posts: 27
Default Aetna - cervical one level

Last year Aetna denied my 2 lumbar disc replacements as "not covered by policy" and the lawyer said since they didn't deny it as "not medically necessary" that I wouldn't win in court.

So, I was pleasantly surprised when I called them to get an update on my one level disc replacement in my neck and they said it didn't require pre-authorization, only pre-notification (coverage determination). Shocking as I needed pre-authorization for a $200 prescription but not for an expensive surgery. Getting one level done is better than none, and it is the one that is symptomatic at this time.

I'm scheduling the surgery now and once it's done, going to try to submit for lumbar again. I'm getting nervous!!!

C
__________________
Chris
Back and Neck Pain 30+ years, Chiropractic care
Several Epidurals and Blocks over past 5 years
Awaiting Insurance for 2 ADR Lumbar L5-S1 L4-L5
Discogram showed Shredded L5-S1
5 YO MRI of neck shows straightening of cervical spine, issues at C4-5 & C5-6 and C6-7 (central disk protrusions, bilateral uncovertebral joint arthropathy, moderate neural forminal stenosis, severe central stenosis with cord compression)
Aetna approved C6-7 replacement, scheduled for 11/17
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