Ongoing Low Back Pain but Denied MRI

I have had bulging disc problems for years. I have been to physical therapy 3 times, had 2 MRIs and received epidural steroid injections. My last MRI and injection was about 5 years ago, and after that up until about 3 months ago, I had not been in pain.

Unfortunately, for the last 3 months the pain has returned. I asked my doctor if I can begin the injections again, and they sent me to an orthopedic center, and they ordered another MRI. I don’t have the scans from the last one I did (I don’t even remember where I had it done, unfortunately) and it has also been a little long since it was done so they want a new one.

My insurance denied the MRI because it is not medically necessary, and they want me to do 6 weeks of more conservative therapy first. Since this has been an issue for me before, and the three rounds of physical therapy were not effective, can I appeal the claim? I have never had this happen so I’m not sure how appeals work or how likely they are to be approved. Unfortunately, I don’t have many records of the treatment I received before since it was all over the place (different jobs, insurance, cities, etc.)

submitted by /u/MurkyBark3955
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