degenerative disc disease operation question

I've previously had 2 surgeries on the same disc (L4) in the past 8 years. After the 2nd surgery, I was informed that I have degenerative disc disease. I've dealt this this pain again for the last 3 years and finally the pain has gotten so bad that I'm talking to a surgeon again. He's telling me that even though he can see that the disc is in bad shape, that BCBS probably won't let him proceed with a fusion operation unless I've done a certain amount of physical theropy. Is this true? If the Dr suggest spinal fusion, will it be denied until I've gone through physical theropy even though it's been determined that I have DDD?

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0 BCBSTX Connect Team over 6 years ago

Hello, There are some requirements that must be met before spinal fusion surgery would be approved. You can view the medical policy here - www.medicalpolicy.hcsc.net/.../search - for more information. Your doctor can also submit a predetermination of benefits request to see if this service would be covered under your plan. ~ Kayla
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0 BCBSTX Connect Team over 6 years ago

Hello, There are some requirements that must be met before spinal fusion surgery would be approved. You can view the medical policy here - www.medicalpolicy.hcsc.net/.../search - for more information. Your doctor can also submit a predetermination of benefits request to see if this service would be covered under your plan. ~ Kayla
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