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  #11  
Old 11-17-2021, 06:21 AM
holliswuzamember
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Here is another source with slightly different information,...you probably have a center that does this closer to you, and you can call with questions.

https://www.tuftsmedicalcenter.org/-...881CD7523D1FF2
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  #12  
Old 11-17-2021, 06:30 AM
holliswuzamember
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OOPS! sorry,

That is a wrong link! That is genicular NERVE ablation,..essentially a pain control procedure,.not something to reduce inflammation,..

It might be something to consider after a knee replacement operation in which you still have a lot of pain,.
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  #13  
Old 11-21-2021, 07:00 PM
BobG too
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Default Aetna considers GAE investigational/experimental

https://www.aetna.com/cpb/medical/da..._699/0673.html
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  #14  
Old 11-22-2021, 05:24 PM
holliswusamember
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Well not sure how old that information is, but I just checked on a large center that does this a bit north of NYC and they said they have had a very few problems with insurance companies paying for it.

Generally they embrace it pretty well as it only cost about 1,500 dollars and a good gamble as total knee replacements start at 55,000 here,.even if the GAE doesn't work and their record of success is about the same as a total knee replacements, it doesn't stop you from having that in the future. BTW many ins companies will have you pay more than 1,500 out of pocket for your contribution of the operation, hospital stay and all the PT involved,..

Again do your own research on it,..but as the interventional radiologists have said ,..probably don't ask an orthopedists because they don't do it, don't have much if any experience with it, don't know much about it,and are in competition with it.

Again I have no irons in the fire to make money promoting this, do it if you want to,..or not.
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  #15  
Old 11-30-2021, 07:40 AM
hookem-1 hookem-1 is offline
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Verrry interesting. I sent the link to my daughter who is an X-ray technician for an orthopedic surgeon.
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  #16  
Old 11-30-2021, 12:05 PM
holliswusamember
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Well though,... did you catch the part that most orthpedic surgeons will tend to put it down as THEY don't do the proceedure and the current knee replacements are a big part of their income .( its like they don'twant to know about it,).. Its done by interventional radiologists ,it might be better to ask one of those about it.
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  #17  
Old 12-01-2021, 08:25 AM
REW REW is offline
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Derwood,
Call the claims number that is printed on your health insurance card, armed with the link to the procedure and simply ask the claims representative for the insurance company as to whether or not this process is covered by your insurance company.
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  #18  
Old 12-09-2021, 05:30 PM
rebelrn2001 rebelrn2001 is offline
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Default Gae

I actually don't recall specifics regarding GAE but when I was working at Humana as an RN reviewing medical claims, we started seeing this come through quite a bit. If you have Medicare, which uses LCD's and NCD and Articles to determine if something is covered or not, the insurance companies typically will allow a procedure IF there's nothing specific in these reference documents indicating that it's NOT covered. Remember, that's only for Medicare plans. I don't recall if the providers were using unlisted codes or not for billing. Your best bet is to ask the provider to do a 'predetermination' or a 'prior authorization'. Then you know if it will be covered or not. I wouldn't take a chance that it will be denied as you'll then be on the hook for the FULL billed amount (not the discounted/allowed amount) that Medicare allows. I'd think there'd be few if any insurances that will cover this if it's considered E and I (experimental and investigational). Remember, virtually EVERYTHING that's done by doctors at one time was E & I. It just takes time for things to be PROVEN that they are SAFE and EFFECTIVE. It's the way SCIENCE works.
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  #19  
Old 12-09-2021, 09:34 PM
peter 345
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I think the centers that do this charge 1,500 here.Not bad as I think many insurances charge about that amount as your out of pocket contribution for a total knee replacement and the results are similar..And there is MUCH less down time afterward.
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