Anthem- RFA experimental- help please

[caedmon]

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Got an RF case denied by Anthem stating it is experimental. I searched the forum as I thought this had been discussed, but couldn't find specifics.

What literature or other arguments have folks on this forum used successfully to get approval?

This patient was previously recommended for fusion for LBP and improved >80% with MBBs.

 

[ghost dog]

Got an RF case denied by Anthem stating it is experimental. I searched the forum as I thought this had been discussed, but couldn't find specifics.

What literature or other arguments have folks on this forum used successfully to get approval?

This patient was previously recommended for fusion for LBP and improved >80% with MBBs.

Just curious: what was the rationale for fusion : instability or pure discogenic picture?

Sorry I can't help you out with the coverage issue ( I practice in Canada).