I think it would be great if you have the energy and appealed. The whole situation is rediculous. The ALJ can see that the rule is rediculous but is not allowed to modify it apparantly. Neurologists and PN advocacy groups are all useless. Where were they when these medicare guidelines were proposed and instituted? Send a copy of the correspondence and decision to Senator Gillebrand. She is up for election this year and has been active on several fronts related to health care.