Got my answer to my insurance appeal...

[sahuaro]

I cannot agree more with all the advice you have been given, especially requesting the clinical guidelines and especially swamping them with studies of the frequency of adjacent segment degeneration and need for further surgeries with fusion. This is just another example of insurance companies pulling any ploy to avoid paying but the first I've seen in which they disclaim responsibility for making a clinical decision.

On a discouraging note, I went through the entire appeal process including going through the State Insurance Department--their "independent" reviewer essentially said that because my plan specifically stated that ADR was experimental, it was not covered, i.e., he totally ignored my arguments against considering ADR experimental.

However, it is now a year later with many more insurance companies covering ADR--which may be why your company is grabbing at straws. So go for it!