Insurance question

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chasema

Good news for me. Insurance will cover Xiaflex or Grafting operation with a small copay. I was asked to go to medical policy G-9-017 of Highmark site and read weather my situation meets criteria of peyronies for approval. I read this policy and got no info that could be understood by myself, since it was written by doctors for doctors. From what I thought it had to be over 30 (mine is about 45degree bend) some pain and some ED issues. Does anyone know for sure? I don't want to waste my time going to doctor just to hear I didn't meet that.  

betterbend

My insurance criteria is curve greater than 30 degrees, symptoms for six months, palpable plaque.  
55 - Onset May 2017.  38 degree bend up.  Failed Xiaflex treatment.  Still functional so I decided to stop treatments.  Only take 400mg Co-Q10 and occasionally use Restorex

chasema

Thanks Betterbend. I have more that 30 degrees but my plaque in not palpable.

TonySa

If they deny based on palpable plaque—appeal based on ultrasound or scan which is more definitive anyway.
PxD 2 yrs 9/16.  Failed all treatment. 9/11/18: excision, grafting & implant Dr Karpman MtnView Ca, AMS CX 18cm + 3-1cm RTEs.
Pump failed.  2/11/20 Dr Karpman installed Titan 22cm +1cm RTE.

chasema