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Dr Basu
Dr Basu, Experienced Specialist
Category: Medical
Satisfied Customers: 29245
Experience:  MD
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I have several autoimmune diseases ( lupus sle,rheumatoid

Customer Question

I have several autoimmune diseases ( lupus sle,rheumatoid arthritis, Graves' disease, spinal
Stenosis, degenerative disc disease).last year I had to have back surgery and I had a lot of complications. Now I have a large bone spur on the end of my spine, and I am in excrutiating pain. I am taking fentanyl losenges along with diludid as prescribed by my pain doctor. Now my insurance company doesn't want to pay for it because it isn't cancer.aren' there cases where one is in almost the same type of pain as cancer? Leslie in San diego
Submitted: 2 years ago.
Category: Medical
Expert:  Dr Basu replied 2 years ago.
Hi there,
This is Dr Basu, Experienced Specialist.
I am here to address your concerns and provide great service.
Yes there are.
In your case, you have multiple level disc disease, with a faile back surgery.
So your chroni pain should qualify for these pain medications as you have exhausted other treatment options.
This is something upto your insurance company --there is no such guideline by the way.
If your pain specialist deems them necessary for your pain managenet that should be adequate to convince your insurance company to pay for them.
You should discuss with your pain specialist so that he can do a peer to peer review to challenge the insurance company's decision.
Another option will be to switch to preferred opiates like oxycontin or oxymorphone.
Best wishes,
It was my pleasure to help you today.
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