So I gather that you are saying Alan really should have the Spinal Tap because that will really tell the tale, right?

Well, all I know is that after we pay the rent, we live on $950 a month which has to pay for all food, clothes, (who buys clothes anymore), utilities, ALL CO-PAYS, there are no incidentals, (we gave up going out or going to dinner or going on vacation a long time ago.

Alan has Blue Cross Midiblue insurance which I am going to call right now.
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Okay, just got off the phone with Alan's insurance company, a medicare HMO.
I explained that Alan has been told he needs a spinal tap. And if they find protein, he will need IVIG treatments. She replies "I have no idea what IVIG is". I sigh and politely say: "All I need to know is, Does Mediblue pay for IVIG treatments?"

She says to me "What are the procedural codes and diagnostic codes for IVIG" I respond. "honey, he hasn't even been told he needs it yet, I just want to know if you cover them".

She responds. "well, unless we get the procedural codes and the diagnostic codes, I can't tell you anything". I asked to speak to a supervisor:

What it boils down to (and she was very clear about this)!!!!!

Alan goes for a spinal tap. If his neurosurgeon feels he needs IVIG, she will know the diagnostic codes, and the procedural codes, she will then call up Empire Blue Cross, Blue shield Mediblue and request that he be given IVIG. They will look up their allowances for these diagnostic codes and if it comes up positive for neuropathy, then it's a go ahead for IVIG. I said to her "Oh, I understand, you mean, you might allow the treatment for a person with Multiple Sclerosis but not for NEUROPATHY!!!
She said "Exactly!!!". She also said 'if it's an investigational treatment, like a new treatment or a rare treatment, then we won't cover it". I told her "it's neither investigational, nor is it rare, and Peripheral Neuropathy has been around for a long long time but you are telling me now that you can't tell me anything until you have the diagnostic codes and the procedural codes, am I right?"

And she said "absolutely".

Then I went "AHA, if the doctor has the codes, he must have gotten them from you, so you MUST KNOW THE CODES".!!!!!!

She goes: "Oh, no, the codes are standard all over the place, everybody uses the same codes, so if you can get the diagnostic codes and the procedural codes, you can call me up and I can tell you if we cover IVIG".


I just went on the internet and found a website for codes for IVIG.

For IDIOPATHIC PROGRESSIVE POLYNEUROPATHY it said 356.4.

Now I gather this is the diagnostic code? I can't get a procedural code because there are tons of ivig treatments for various ailments, but AT LEAST I GOT SOMETHING.

........this journey is just beginning, I can tell.........

mel