64 slice CT scan

[Jillejam]

I want to know if anyone out there has had the 64 slice CT scan and if they got their insurance to cover this darn thing.  I am in the middle of trying to get my insurance to pay for this test before I get it done.  Please any help in this matter would be great.

Thanks
Jill

[Jack54]

You are so kind with your compliment  :) Although I must deny knowing much at all about the heart. What I have learned since an mi in 2003, has come from people like yourself and the wondrous google. I have stayed on the computer too much I guess. Back in 03, I found out that doctors do not explain a lot, due to time constraints, and a lack of assertiveness among the patients.

I have small vessel disease (SVD) and found out from my ophthalmologist yesterday that I have damage to both of my retinas from very early stage macular degeneration. The tiny arteries that supply my retinas are diseased. I can have this amazing surgery that is new, to save my vision. They are saving the sight of folks with diabetic retinopathy already. Sorry to dump this on your thread, lol.

Baptist Hospital has a great reputation, but I don't know how it rates with Vandy as far as cardiology. Personally, I check the hospital's website and study the credentials of their doctors. If the hospital does not have this information, I go to the AMA doctor finder. If they are a member of the AMA, there is loads of background info on them. If not, they do mention s/he is a doctor :)

Then I look at the volume of surgeries done by the staff, or Cardio/Thoracic surgeons. I just now realized you are speaking of aortic valve repair/replacement.....I had bypass surgery on my mind for your Dad. I am still asleep I think...I have an evaluation for bypass surgery the 21st of September. It may be on my mind, lol.

No doubt where he needs to go to for that, the Cleveland Clinic is the only hospital I would let perform this type of procedure. They do more valve surgeries/repairs than any hospital in the world. Just like with coronary artery bypass surgery, they have pioneered valve repair and replacement procedures. They were the first to "repair" a heart valve I believe.

Another famous valve surgery/repair institution is the St. Louis University Hospital, and the Texas Heart Institute. At the CC, the doctors there do not have outside "practices". They only work for the hospital and are paid a salary. I had a stent inserted there 3 months ago. My doctor was a genius with a big ole heart :)

Has your Dad had a TEE test yet? It is very important that your Dad stays sedentary, until his valve is repaired/replaced. If not, he runs the risk of enlarging his heart due to overworking it.

I think Vandy would be a great place to get a second opinion, as to the condition of his valve. If you do not understand what is actually happening to the body when an aortic valve leaks, let me know. Has an echocardiogram estimated the leakage past his aortic valve?

Hope all goes well for him.

*Preexisting conditions are  sometimes not covered, or there is a certain period of time.

Good luck with all :)

Jack

[Jillejam]

Jack
Is there anything you don't know about regarding the heart?  It seems that you sure have a vast amount of knowledge.  I am very impressed!  I am new to this whole thing, my problems started in July and I know enough to be dangerous.  I am also trying to learn about aortic valves...my father is going to need replacement this next year.  Jack...you know about docs in TN don't you?  My parents live in TN and he is seeing one from Nashville.  I was thinking that maybe he needs a second opinion.  I thought I saw you say once something about Vandy in Nashville.  I had my defibrillator put in at Baptist Hospital in Nashville while I was on vacation.  I was very happy with the EP doc that put it is but my dad needs an open heart guy.  I would appreciate any help you can offer.
Thanks
Jill

[Jillejam]

I am so sorry to hear about your problem, that really sucks.  I am lucky that I have met all my deductibles and copays for the year.  The only problem is that they may not pay for the test.  The nurse that schedules the tests at my local hospital told me that BCBS of Illinois has been denying all claims.  I talked to a rep from BCBS and she then called my dr office and talked to someone in the billing dept.  Supposedly she asked the biller how she would bill it....she was told of two different billing methods, the BCBS rep told the biller that one of the ways would be covered and one of them would be denied.  I am in the middle of trying to find out if my test would be billed the correct way.  This is such ****, I was trying to get this test done in the next 10 days before my biopsy but now I am thinking I will wait til afterward.  Another ? for anyone out there.  What happens if you switch jobs and change insurance policies....can they deny you on the fact that you have recently have had major costly things done to you.  I have never had a lapse in coverage in the past 10 years, does this matter.  Please let me know!
Thanks!
Jill

[Jack54]

Monday, April 4, 2005
Brilliance 64-slice CT Scanner by Philips
Filed under: Cardiology , Radiology


The University of Chicago Hospitals have installed the Brilliance 64-slice CT scanner by Philips, the first such system in the US. From the recent press release:

The second 64-slice computed tomography scanner ever produced by Philips Medical Imaging, and the first to reach the United States, has been installed and is now in clinical use at the University of Chicago Hospitals.

http://medgadget.com/archives/2005/04/brilliance_64sl.html

[Sweetwaterguy]

I had one done six weeks ago.  The provider told me that Blue Cross/Blue Shield would not pay for it.  They called it "investigational."   I learned today they actually did pay for it, less the deductible.  
That may be bad news for me because I negotiated a price in advance that I would pay the Medicare reimbursement rate.  Because I have a relatively high deductible, now that BC/BS has paid, my portion is going to be more than I had originally negotiated.   The provider also indicated they were very surprised my insurance paid, because they have turned down all the others.  I should mention the 64 slice ct has only been up and running three months.  

[Jack54]

Have you called customer relations at your insurance provider and asked if there are any conditions where they do cover the 64 slice ct scan?

Is your doctor specifically asking or wanting a 64 Slice Coronary Artery CT Scan? This 64 slice ct technology is being used for all organs/parts of the body. I don't know if he could change the reason for the test though. Your insurance may not pay for this latest computed tomography scanning. That is outrageous if so....Your insurance company should have a web site showing your coverages, and special test coverage also. Check them out.

I would complain to my state board of insurance....whatever it's called, if this test is not covered.

[Jillejam]

I already have had an angiogram and am having a biopsy on the 11th of Sept.  I just don't know how much I should fight for this test.  I know my doctors will fight on my behalf with the insurance company, maybe I should just wait til I have my biopsy.  There aren't many tests left that haven't been done on me, only ones would be stress tests.  My doctor wants the CT to see if perhaps a car accident could have caused my problems before we find out if I really do have ARVD (Right Ventricular Dysplasia).  ARVD is mostly a genetic disorder, really hoping I don't have this.  I really don't want to find out that my sons could be possible carriers of this disease.  Anyway, thanks for all the feedback on the CT scan, I am so mad at the insurance companies right now.  Who do you contact to complain about the lack of coverage on such a valuable test.  By the way, my hospital wants to charge 1300 and another one wants 1500 bucks...I am only 37 with two small children, I can't afford to shell out that much on top of all my deductibles and copays.  AARRRRGGGHHH!  
Thanks
Jill

[tanns]

Florida Hospital will do one here for $1,050.  Not small change by any means but a great deal better than the over 4K they charged my insurance.  Get your docs office to fight for you, mine did and it was covered.  

Good luck and I hope you get it covered!

[va_tony]

My Aetna insurance refused to pay even though my cardiologist fought for me and it was justified based on an abnormal nuclear test. Rather than have a cath-angiogram, I paid for the CT-A out of my own pocket ($900) just to avoid the hospital stay.

[Jack54]

I had one about 1.5 years ago. My insurance had just negotiated coverage of this test. So it paid for it (bcbs). The test was 100% accurate as shown by a cath 4 days later. Believe it or not, separate from the cardiology interpretation was a page that listed other conditions mainly concerning the lungs. You have to get the actual test results though, to see the non-cardiac related data. No one ever mentioned these findings to me or my PCP. I had evidence of previous granulomatous disease and nodes in my lungs.

There are certain criteria used to justify the test. I forgot exactly what they are, but your doctor must be behind you.

I would suspect that age is one prerequisite. Another is that you should probably have had a nuclear stress test with positive results for myocardial ischemia.

This test gives a high dose of ionizing radiation.

Good luck :)

Jack