Good day
W M KRIEL- MEMBER NO 02025406773
PRE AUTHORISATION NO 70583970
On the 31st January 2013, I saw a Neurosurgeon with regards to a numb feeling going down my
Neck into my right arm, then down the right side of my body.
After an MRI scan, and XRAYS, my doctor said he would like to do a cervical Rhizotomy, as well
as lumbar infiltrations on the 19th February 2013. He gave me the codes 2927, 0201 and 3287. I was told that the code 2927 was an exclusion, I am still to find this in the literature sent to members.
I went back to the doctor and explained that this code 2927 was an exclusion.
After lengthy calls to Tanya at the customer care call centre, I was then referred to a lady
dalled Anna who is in the Clinical case management department. After a lengthy discussion, I was advised by Anna they would only authorise the following codes 2831, 0661, 2829 or
2793. I then went on a major chase calling the specialist back and forth to the call centre.
It was then agreed with the specialist that the code 2793 was the code to be authorised.
but to no avail - wrong advise given by case management.
the procedure was not done after being given the codes by case manager.
0 comments