AIM denials

[Crybaby]

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Things that make my blood pressure high- AIM denials. Everything is freaking "experimental" and "does not meet their "diagnostic criteria"
I know I am not alone. Who else is dealing with this BS and how can we fight this.

 

[deleted185747]

If you’re in network you can only offer what is covered.

 

[10KHertz]

If you appeal enough and fight enough, they usually tell you what to put in your notes... persistence.

 

[painfree23]

If you appeal enough and fight enough, they usually tell you what to put in your notes... persistence.

no one got time for that

 

[10KHertz]

no one got time for that

Get better staff...

 

[Crybaby]

Reading through the guidelines it really irks me that there are no exceptions. They are drastically limiting levels that can be done for facet/mbb. I am usually very conservative with levels chosen, but every once in awhile I have a POS spine that comes in and deserves 4 level bilateral. I hope someday if I have that type of pain and pathology that some pain doc will take pity on me🙂
I recently got denied payment on an SI joint because I put steroid into the joint 6 weeks apart. Patient had great short term relief, but no long term relief on injection #1. Gorgeous arthrogram too.
Who has changed to differentiating between diagnostic and therapeutic SI joint injections and actually putting only local into a SI joint injections deemed diagnostic, I feel like this is a waste of time. I know one of the SIS speakers mentioned during a conference that he only places local for the first injection.

 

[10KHertz]

Reading through the guidelines it really irks me that there are no exceptions. They are drastically limiting levels that can be done for facet/mbb. I am usually very conservative with levels chosen, but every once in awhile I have a POS spine that comes in and deserves 4 level bilateral. I hope someday if I have that type of pain and pathology that some pain doc will take pity on me🙂
I recently got denied payment on an SI joint because I put steroid into the joint 6 weeks apart. Patient had great short term relief, but no long term relief on injection #1. Gorgeous arthrogram too.
Who has changed to differentiating between diagnostic and therapeutic SI joint injections and actually putting only local into a SI joint injections deemed diagnostic, I feel like this is a waste of time. I know one of the SIS speakers mentioned during a conference that he only places local for the first injection.

Your predecessors screwed the field.
For example, Boston scientific in-office 16 contact lead SCS trials on Sunday afternoons to pay for the yacht...

 

[geauxg8rs]

Your predecessors screwed the field.
For example, Boston scientific in-office 16 contact lead SCS trials on Sunday afternoons to pay for the yacht...

Two 16 leads in epidural space and two more 16 s in subcutaneous space.

 

[painfree23]

Two 16 leads in epidural space and two more 16 s in subcutaneous space.

Paraspinal stimmm

 

[DOctorJay]

Two 16 leads in epidural space and two more 16 s in subcutaneous space.

Or simply draped on top of the back for the fluoro image alone. I’ve heard of that happening.

 

[Ducttape]

Reading through the guidelines it really irks me that there are no exceptions. They are drastically limiting levels that can be done for facet/mbb. I am usually very conservative with levels chosen, but every once in awhile I have a POS spine that comes in and deserves 4 level bilateral. I hope someday if I have that type of pain and pathology that some pain doc will take pity on me🙂
I recently got denied payment on an SI joint because I put steroid into the joint 6 weeks apart. Patient had great short term relief, but no long term relief on injection #1. Gorgeous arthrogram too.
Who has changed to differentiating between diagnostic and therapeutic SI joint injections and actually putting only local into a SI joint injections deemed diagnostic, I feel like this is a waste of time. I know one of the SIS speakers mentioned during a conference that he only places local for the first injection.

A couple of workarounds that sometimes works.

there is nothing to prevent you from asking for 2 bilateral median branch blocks of the L23 and L45 levels. Or C34 and C56.

I have been taking to doing diagnostic SI injections. Bad and good for patient. I have been doing more SI injections per a specific patient but actually about the same total across the board, since I have had a few negative diagnostic injections. But ppl don’t get steroid exposure if it doesn’t work.

 

[painfree23]

Or simply draped on top of the back for the fluoro image alone. I’ve heard of that happening.

The Lateral must be challenging

 

[10KHertz]

The Lateral must be challenging

Especially with Nevro , who required a lateral confirmation for their superiority rating at the onset .

Not boston scientific, however, they led the fraudulent abuse of SCS trials ... or at least incentivized it .

 

[Dr. Ice]

A couple of workarounds that sometimes works.

there is nothing to prevent you from asking for 2 bilateral median branch blocks of the L23 and L45 levels. Or C34 and C56.

I have been taking to doing diagnostic SI injections. Bad and good for patient. I have been doing more SI injections per a specific patient but actually about the same total across the board, since I have had a few negative diagnostic injections. But ppl don’t get steroid exposure if it doesn’t work.

I have a problem doing SIJ interventions in general let alone considering diagnostic and then separate therapeutic injections. I think I became more or less disgusted by si fusions and that has caused my pendulum to swing so far away from SIJ as the pain generator unless there is “compelling” clinical evidence for it, or nothing else has worked or fits

 

[10KHertz]

I have a problem doing SIJ interventions in general let alone considering diagnostic and then separate therapeutic injections. I think I became more or less disgusted by si fusions and that has caused my pendulum to swing so far away from SIJ as the pain generator unless there is “compelling” clinical evidence for it, or nothing else has worked or fits

Agreed, I don’t see sacroilliitis as a catastrophic condition.