TRICARE APPROVES Hip Resurfqcing 2016

Original PDF TRICARE Manual Here

4.10  Hip resurfacing (CPT2 procedure codes 27125 and 27130, and HCPCS S2118) with an FDA approved device is proven for the treatment of Degenerative Joint Disease (DJD) of the hip in patients who are less than 65 years old and who meet all of the following criteria:
  • Have chronic, persistent pain and/or disability;
  • Are otherwise healthy and active;
  • Have normal proximal femoral bone geometry and bone quality; and
  • Would otherwise receive a conventional Total Hip Replacement (THR), but are likely to outlive a conventional THR implant system’s expected life.
Read the rest

New Data Reinforces the Proven Safety and

New Data Reinforces the Proven Safety and
Effectiveness of the BIRMINGHAM HIP Resurfacing System

80-percent of US surgeons choose the BHR hip
as it outperforms all other metal-on-metal resurfacing devices

MEMPHIS, Tenn., May 3 /PRNewswire-FirstCall/ — Recent new data(1)
presented at this year’s American Academy of Orthopaedic Surgeons (AAOS)
annual meeting reinforces the BIRMINGHAM HIP™ Resurfacing (BHR) System
as a safe and effective hip resurfacing device. The multi-site study,
performed by orthopedic surgeons practicing at nine Canadian academic
centers, showed that three years after surgery, 99.91% of their 3,400
hip resurfacing patients experienced no implant failure due to metal
wear … Read the rest

Possible Medicare Coverage of Hip Resurfacing ***IMPORTANT***

Medicare is going to decide if it should start discussions
about covering Hip Resurfacing soon.  I am explaining this in layman’s terms. 
There are long processes that government goes through with technical terms, but
basically the public is invited to comment on what procedures will be discussed
for approval.

This is a chance for all hip resurfacing patients and
potential patients to make comments to Medicare. I have been told that Medicare
listens to surgeons, patients, patient advocates and the general public.  This
is an opportunity for hip resurfacing to be covered by Medicare.  I have also
been told that … Read the rest

Medical Vacations: The Retiree Health-Care Solution?

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August 12, 2008

The debate over U.S. health-care reform rages on. But why wait for someone
else to dictate your future? You have many options — if you’re willing to take
a vacation. If recovering from a medical procedure while lying on a palm-swept
beach, relaxing by the hotel pool, or shopping for terrific bargains sounds
good, then medical vacations may be exactly the right solution for you.

From hip replacement to heart surgery, more people are discovering the
advantages of traveling abroad for their medical needs.

A big growth industry
In … Read the rest

Hip Surgery In India? Insurance May Pay

June 2008


Timmi Ryerson, a San Diego stock market analyst, says her left hip actually
works again, thanks to an orthopedic specialist in India.

…What’s new about these procedures is not the exotic locales the three
chose, but the way they paid for their far-flung surgeries.

While at least 150,000 Americans travel abroad for medical care every year,
according to the American Medical Association, Ryerson, Mason and Davies
represent a small but growing category of medical tourist: patients whose
insurance companies have agreed to foot at least part of the bill.

"I think that’s the solution to our … Read the rest

Private Insurance Not Available for 76% of Uninsured Americans

Need health insurance? Better get to work
Do research to find the best individual plan

By Jane Glenn Haas

If you are too young for Medicare but considering leaving a job that offers
group health insurance, it pays to do some research.

After a yearlong investigation, Consumer Reports has concluded that 89 percent
of the people younger than 65 who look for individual health insurance do not
buy it because it is too costly, because they are turned down for health reasons
or because benefits are inadequate.

"Private insurance is virtually out of the question for … Read the rest

Alan Ray Insurance Appeal Letters

By Alan Ray  LBHR with Dr. De Smet  12/15/2004 

THE APPEAL LETTER TO CIGNA (NAU IS "national appeals unit") 
 I have received your written notice, dated Aug. 27, 2004, denying my initial request for pre-authorization for left hip surface arthroplasty. With this letter and attachments, the request is being re-submitted for further consideration as an appeal of the initial denial.
 I am a 55-year-old male diagnosed in March of this year with end-stage osteoarthritis of the left hip, with “some component of dysplasia”.  The result of the condition is that I am unable to engage in the … Read the rest