← Return to Swelling and stiffness, 3 years after total knee replacement

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@contentandwell

@gardeningjunkie Many people have great success with stem cells. It is not 100% successful though and very few insurances cover it, although I have no idea if Medicare does. If you are in pain though it’s worth a try if you can afford it.

I had a procedure done before I was on Medicare that my regular (BC-BS) would not pay for without a pre-authorization. Then they still rejected it and I had to fight for them to pay. The funny thing was that it is covered by Medicare, maybe because it was a kyphoplasty to repair a broken vertebra and that is more common in people who have osteoporosis, which I did not, at that time so even though regular insurance does not cover it maybe if your doctor will plead your case it will get covered.
JK

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Replies to "@gardeningjunkie Many people have great success with stem cells. It is not 100% successful though and..."

It's interesting what Medicare will cover. I had to sign a form specially informing me Medicare would not cover it, but with my history what choice did I have. I figured I would have nothing to loose by appealing and the very least I would have the satisfaction of at least getting them to read the stack of documents I sent. I sent off pages of documentation which included my allergy history and documentation of previous allergy tests (covered by Medicare) and finally got my doctor to write a "letter of medical necessity" based on my allergy history. This took some doing as his office told me Medicare would not cover this test so it was a waste of time. In truth I am shocked that Medicare will not cover this test because allergic rejection is not rare. I am beginning to wonder if the surgeon doesn't want tests like this done as it would discourage surgeries. This entire gorgeous brand new hospital w is designed inside and out like a 4 star hotel is for orthopedics only and has multiple surgeons; joint replacements are taking 3 months to book. Lack of business is not an issue. This is not a major metropolitan area- it's in the city of Ozark on the outskirts of Springfield, MO a mid-size city. In the appeal I included copies of the blood allergy test showing my positives and explained that because of results I could not be a candidate for a knee replacement, plus included documentation of the alternative ceramic implant which many are rejecting and copies of the class action lawsuit. In a personal letter of appeal I also wrote up how much money Medicare would be saving because I would not be having a knee replacement plus if I had not had the test and gone ahead with the surgery the expense of future surgeries would be massive. I am not sure they cared about my pain or suffering, but I do because after rejection and removal I would be left completely crippled without a knee joint. I sent all this off 3 weeks ago and checked that it was received. As expensive as this surgery is it seems this test should be mandatory.

I’ve had PRP—worked for a while. But my regenerative medicine doc told me stem cell therapy is on hold by the FDA. 😞