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Old 11-06-2014, 03:46 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!!!

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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Old 11-06-2014, 09:17 PM
Harrison's Avatar
Harrison Harrison is offline
Join Date: Oct 2004
Posts: 6,946

Congrats, Chris! Keep us posted.
"Harrison" - info (at)
Fell on my ***winter 2003, Canceled fusion April 6 2004
Reborn June 25th, 2004, L5-S1 ADR Charite in Boston
Founder & moderator of ADRSupport - 2004
Founder Arthroplasty Patient Foundation a 501(c)(3) - 2006
Creator & producer, Why Am I Still Sick? - 2012
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Old 11-07-2014, 08:37 AM
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colorado babe colorado babe is offline
Senior Member
Join Date: Aug 2014
Posts: 345

Yes, congratulations and keep us updated. Maybe if you get the one level now you can get the second level done next year? I know Tricare started approving one-level cervical ADR's on May 1, 2014.
1998- Injured neck and back in USAF
2011 - Started experiencing Severe Symptoms, Migranes, numbness, spasms in legs and feet and sciatica.
Feb 2014 - Received upper Lumbar Injection - Severe Allergy to injection
Mar 2014 - MRI of Cervical and Lumbar, protruding disc in C3-7, Herniated Disc in L5/S1, placed on STD and FMLA )
July 2014 - Stem Cell Procedure performed
Oct 20, 2014 - ADR (MOBI-C) at C5-7 and Anterior Fusion at L5/S1 by Dr. Pettine and Dr. Techy
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