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Old 12-13-2013, 02:11 PM
1Day 1Day is offline
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Join Date: Oct 2013
Posts: 27
Default Aetna

So, Looks like Aetna has a new Clinical Policy Bulletin ADR lumbar is now considered experimental and they don't cover it.

They first denied me in July as not medically necessary, now they denied it because they changed their policy in September.

Said I can appeal to the California Dept of Insurance...
__________________
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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