Does Medicare Accept Botox Injections?

Discuss here about Medical Disability claims and Insurance possibilities for PN treatment options

Does Medicare Accept Botox Injections?

Postby lexie » Mon Apr 16, 2012 1:24 am

Hell o all,
Spoke with Dr. hibner office who said I may need botox injections into my pelvic floor, oburator and ppossibly other area. the cost they told me is $2,500 per injection. I have medicare and no secondary. My dr. in san fran does botox cheaper Dr. Weiss but uses only half the dose that dr. hibners office use. Does hibner use a radiology guide or freehand. botox I had before is very painful more than a nerve block whichsurprised me.

How long does it take for botox to kick in and know if it ha helped. it only to release a spasm right? If it doesnt help then all my savings are gone and I am up the creek.

My pain I have found myself is coming from the thick rim of muscle jut inside the vagina. IF i push on it it aches me terribly, this ache I get when I sit. I beleive the sharp shocks are coming from this area too.....is that the pudendal nerve what area is the thick rim of hard muscle it feels like bone it is so hard u know. could it be the dorsal nerve as i gt clitoral ache on and of but not realy anything but the odd sensation in the clitoris.
its all in the thick muscle rim---god its horrible cannot sit at all now and walking limited. Holding my urine during the night made this worse for me as I was up 5 times going to the bathroom which is normal for me at night now, nearly every night.I have not been uisng my HRT homonal patch for months and am experiencing chronic dry eye feels like my eyes are scratched all thetime could also ahave vaginal dryness and can tha cause stinging vaginal sharp pain too.---thnks lexie
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Re: Does Medicare Accept Botox Injections?

Postby Violet M » Sun Apr 22, 2012 2:39 am

Lexie, check with Dr. Poree about Botox injections. Karen W was seeing him and last I heard he was in the same building as Stephanie Prendergast's clinic.

Also, check into cpt codes and see if there is a good way for it to be coded so medicare will cover it.

Violet
PNE since 2002. Started from weightlifting. PNE surgery from Dr. Bautrant, Oct 2004. Pain now is usually a 0 and I can sit for hours on certain chairs. No longer take medication for PNE. Can work full time and do "The Firm" exercise program. 99% cured from PGAD. PNE surgery was right for me but it might not be for you. Do your research.
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Re: Does Medicare Accept Botox Injections?

Postby Violet M » Sun Apr 22, 2012 2:42 am

One more thing Lexie -- before trying Botox, I read that Dr. Gajraj does an injection with lidocaine to help predict whether Botox will even be helpful. So you might want to try that before going for the Botox.
PNE since 2002. Started from weightlifting. PNE surgery from Dr. Bautrant, Oct 2004. Pain now is usually a 0 and I can sit for hours on certain chairs. No longer take medication for PNE. Can work full time and do "The Firm" exercise program. 99% cured from PGAD. PNE surgery was right for me but it might not be for you. Do your research.
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Re: Does Medicare Accept Botox Injections?

Postby lexie » Fri May 25, 2012 2:14 am

who is Dr. gajraj for the lidocaine..where is he located, I am in san fran currently.?
thanks
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Re: Does Medicare Accept Botox Injections?

Postby Violet M » Sun May 27, 2012 5:12 am

Dr. Gajraj is in Texas but you wouldn't have to go to that far. Check out the doc I mentioned in my previous post who is near Stephanie Prendergast's office in San Fran. (I'm sorry -- I don't think his name is Dr. Poree -- he's in Monterey) I can't remember what his name is.
PNE since 2002. Started from weightlifting. PNE surgery from Dr. Bautrant, Oct 2004. Pain now is usually a 0 and I can sit for hours on certain chairs. No longer take medication for PNE. Can work full time and do "The Firm" exercise program. 99% cured from PGAD. PNE surgery was right for me but it might not be for you. Do your research.
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Re: Does Medicare Accept Botox Injections?

Postby quilter » Thu Sep 05, 2013 1:31 am

I had Medicare primary and Blue Cross of CA secondary when Dr. Hibner did my pelvic floor Botox in 2010. Not sure how he coded it or got it authorized, but both insurances covered the in-hospital outpatient procedure with no hassle before or after by his office or me. I wasn't asked to pay anything up front. Months later I was billed maybe $400 total in co-pays between him, St. Joseph's and the anesthesiologist. About the same cost as my flights. It sounds like things may have changed since then, though if Medicare goes by precedent they covered me. I could try to dig around for the billing if it would help.

Medicare and I think Aetna also covered nearly all of my PN decompression in 2007 with no battles up front or afterward either.
Acute left vag/rectal pain 1999 lowering into chair. Dx 2006 with PNE/VV by PTs, Dr. Garcia, Weiss, Hibner. Many shots. PNMLT: left PN barely fuctional. Left TIG by Dr. Hibner 2007 (ST lig). 75% improved 1 year postop, slow decline. Pelvic floor Botox 2010. Left sacral SCS 2011 after good trial; removed 2012 due to NEW left S2 & rectal pain, bowel freq. Re-do left TIG by Dr. H & 5-day ketamine 2013; 1-1/2 years postop 70% improved. New post-SCS Sx are worse than PN Sx.
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