My 87 year old father is being denied cataract surgery. He was diagnosed with small cell stage 3 lung cancer in November 2009. He had one chemo capsule the beginning of December. No other cancer treatment since that point of time. He just had blood work done a few days ago. From what I understand his blood work came back good, it doesn't appear as if his cancer has spread...his kidney count is a bit out of the norm. Other than insurance denial, what reasons would there be to deny him cataract surgery?
Optical - 1 Answers
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I am an optometrist in the USA who refers patients for cataract surgery and co-manages them with the surgeon after the surgery. I have to admit that I avoid trying to understand too much about insurance in an effort to preserve my own mental health. The only criteria that I am aware of for insurance coverage of cataract surgery is the quality of vision. Normally best corrected vision has to be 20/40 or worse. Sometimes even people with better vision than that qualify because they fail a glare test. A glare test involves shining a light in your eyes and asking you to read a chart. Everyone will see worse with a light in their eyes but people with cataracts usually perform much worse. I am unaware of any clinical reason why the surgery would be inappropriate. I am quite sure that life expectancy is not a factor in approval. I have found that some surgeons are more aggressive in getting approval than others are. You may want to try another surgeon.
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