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How Do I Prove Medical Necessity of UPPP? (photo)

razor2000Sep 26, 2012
Insurance denied my UPPP because my AHI is 9.4. Anthem Blue Cross's standard for medically necessary is AHI 10-15. I have been on CPAP, BIPAP, even AVAP without relief. CPAP prescribed 1 yr ago. Dr's disability papers state standard therapies as ineffective. My nasal pharyngeal wall collapses and the UPPP includes pinning back the rear wall as well.

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Todd C. Miller, MD

I would avoid picking your nose. It is much more effective to thoroughly rinse your nose with saline nasal rinses 2-3 times per day to keep the nose clean and free of crusting. I would make sure that you are following up with your surgeon to ensure that you are healing normally.

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Babak Azizzadeh, MD, FACS

I suggest seeing your plastic surgeon as quickly as possible as this is not common. You may need to also undergo an ophthalmology evaluation. Without examining you, it's difficult to say what exactly the problem could be.

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David C. Pearson, MD

It's absolutely expected that you wouldn't see much effect yet. If the Kenalog is going to work it usually takes a month or more to show results, especially if your surgeon was appropriately conservative with the amount and concentration of the steroid. If I use Kenalog on a patient of mine it's...

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