MRI imaging of spine insurance denial
Has anyone in the USA had insurance successfully cover MRI imaging of the spine who had normal X-rays first?
Premenopausal woman here with osteoporosis of unknown origin at this point (thorough secondary cause workup showed nothing so far and awaiting results of genetic test). (Please don’t tell me to eat healthy and lift heavy weights or to get xyz test as I do and have done!)
I’ve been using a few different AIs to guide me through my osteoporosis while I wait for my appointment with a top bone health clinic. The various AIs have consistently recommended I get MRI imaging of my spine given my severe T scores and severe back pain through recent pregnancies and postpartum. Also my fracture history of ribs and tail bone (4 fractures). I already did X-rays and they didn’t show anything, as predicted, as they miss a large portion of non-displacement fractures and do not pick up on other important issues. Insurance is still denying it.
I plan to use AI to help me craft an appeal based on medical protocol. There’s a good chance my primary care doc didn’t use the right language or mention the right things in requesting the pre-authorization, as she is not that knowledgeable about pre-menopausal osteoporosis.