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Fibrosure question.
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Fibrosure question.

Hello all, long time lurker first time posting. I was dx with HCV and im geno type 1b, my gp sent me to a hep doc. my first visit there he told me he was going to redo the blood test on me as (i didn't look the type to have HCV) at the time not knowing anything about HCV i didn't question him on his statement. Went back two weeks later and he told me it wasn't a false positve and i did have HCV, at that time i asked him what he had meant on my first visit, he just gave me a look and just wanted to rush me out which was find with me. Until i can find another hep doc. I am going to have the fibrosure test My gp doesn't know anything about the test, The only thing we found was that you need to fast for 8 hrs. Can anyone tell me if this is right and if there is anything else i need to do before getting the test? And also does medicare cover any of the cost of the test? Thanks for any help as i have found this is a great group....John
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Avatar_m_tn
John,

Welcome to our discussion group.

Fibrosure sounds like an excellent idea at this point. Your new doc might want to back it up with a needle biopsy -- maybe not -- but the more information the better.


Eight hours fasting sounds right, but you can get complete information, including local blood-draw centers, at Labcorp's web site. http://www.labcorp.com/

I'd also get copies of all the blood tests, including the first, both for your own records and to bring to your new doctor.

Try to find someone who specializes in treating hepatitis c. Generally they're called heptologists and you can find them at larger teaching hospitals.

Good luck.

-- Jim

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Avatar_n_tn
Hello, I also dx with Hep C 3.5 years ago. First thing was liver bx by needle. In July of this month I did the Fibrosure test and took it to 2 Hepa docs and both said it is not a good diagnostic tool at this point and suggested I do another needle bx. Glad I did. The fibrosure came back stating I had Cir. I also went ahead and did the needle bx and it read the same as three years ago Stage 1, grade 2. That was my deciding factor on doing tx or not right away. Go for the needle bx. Its not that bad and gives definite results.
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Avatar_n_tn
Grrrrrrr.....doctors!!! I wonder what "type" I look like?? Who ever said "ignorance is bliss"?? I hope you find a REALLY good doctor who actually knows something!

About the test, I had one about 3 years ago when it was relatively new and somewhat unusual. As I remember, I had to fast overnight and they actually had me take the kit to the lab where they drew blood and then sent it to somewhere in California. Someone at the lab screwed up and I had to do it twice, but finally got the results ok. By now I'm sure it's a piece of cake - all you need to do is be hungry a few hours and give up some blood to the vampires. When I had mine done I had to pay for it myself as my insurance wouldn't acknowledge its existence. I hope things have changed since then. As I remember it was about $350. It was worth it though just for the peace of mind it brought me.
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Avatar_f_tn
hi john, welcome to the "you don't look like the type club", definetely sounds like a new doc is needed, check this site for options: http://www.hepcprimer.com/patient/doctors.html
I am sure the dr will give you written instructions on how to prepare for the test, if not, contact the lab.
Is it Medicare or Medicaid you are receiving? I know Medicaid is paying for more hep c stuff in NY, but it might not be the same in other states, for Medicare, I would call their 800 # and ask.
GL
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43671_tn?1205934471


<font size="3" color="#6600CC">Welcome to the Forum....As you have seen, this is a great place to learn and deal with many of the questions and emotions that come with dealing with HCV.

I can't give much more advice then thats already be given...Other then learn as much as you can about HCV and find a Dr that you feel comfortable with. I agree, the Fibrosure test would be a great place to start.

Here is another great web site that will help you learn much..

   <a href="http://janis7hepc.com/">Janis web site</a>


                    Blessings......

                    TonyZ</font>
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Avatar_n_tn
Don't know about the Medicare coverage, but my Insurance wouldn't pay because the test isn't FDA approved. I got a false reading because I have a Mechanical Heart Valve.
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Avatar_n_tn
I had a Fibrosure Test a couple of months ago.  I was not instructed to fast before the test.

Susan
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Avatar_n_tn
Yes, I was told not to eat anything for about 8 hours before.
I had a copymt of $l00, and my insurance paid the rest. I believe it was about $350.00
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Avatar_f_tn
Thanks for that link Jim, I got the CPT codes for the Fibrosure test which I will take to the docs this Thurs. My question is I noticed someone said it's not FDA approved, how can insurance company's pay for it if it is not approved?

That brings up the question of Medicare, why don't you call them and ask if they pay for it? You will need the CPT codes which there are several, I don't know why there are so many but here they are: 83883,83010,82172,82977,82247,84460. Keep in mind labs are paid at 100% by Medicare unless they are not medically necessary or are experimental...They might try to get you to sign an 'ABN' = Advanced Beneficiary Notice = which would make you financially responsible for the test. If you refuse to sign it they probaby won't do the test. The good news is if they don't offer you the ABN, THEY are financially responsible for the test if they perform it and it is denied by Medicare. Theoretically (spelling?)you were not aware that it would not be covered and therefore can't be held financially responsible! Ha! Little known factoid!  

I would love to know what Medicare says either way so let us know ok?
Cin
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Avatar_n_tn
Thanks to all for your help, and quick responses. Will let ya know if medicare covers the cost. Its nice to know there is a site with so many caring people. Again thanks and the best of luck to all...John
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Avatar_m_tn
Googled fibrosure, here was #1 response.  Note that it does say to fast for at least 8 hours prior to test.

Hepatitis C Virus (HCV) FibroSURE
      
Number
550123
CPT
83883; 83010; 82172; 82977; 82247; 84460
Synonyms
FibroSURE; FibroTest; ActiTest
Specimen
Serum
Volume
3.0 mL
Minimum Volume
3.0 mL
Container
Red-stopper tube or serum gel separator tube
Collection
Separate serum from cells within 1 hour. Protect from light.
Storage Instructions
2
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Avatar_n_tn
Wonderful information on medicare.  It must be your field.  Sure is great to have a medicare expert here.  How are you feeling?  ARe you going to find another doctor and try again?
Kathy
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Avatar_f_tn
Yep, I work in the Patient Accounting dept of a hospital, I specialize in Medicare and Blue Cross. Any time you want tips on fighting an insurance company, ICD9 or CPT codes, whatever, just holler.

I have an apt. today with my regular doc and the gastro tomorrow. That darn rash is killing me plus I have this weird lesion on my nose that popped up just this last Sat...One of my many problems has been painful lesions inside my nostrils, in particular this one spot that has not gone away in months...the ENT says it is from chronic sinusitis draining and causing irritation...a theory I dispute...so directly above the inside area is where the outside lesion popped up, it has a raised border, scabey area in the middle and is red...I am afraid it is Basal Cell Carcinoma so I called the dermatologist who can't see me till Sept...I called my PCP and said I need to come in for a bx right away and 'I dont want to be told to go here and there, I want the bx when I come in that day' I could hear the girl asking somebody and finally she said my doc will see me and do it... I will appologize to him for being so demanding but it's a quality I have grown to realize is my right as a patient...If I wait for those knuckleheads to decide what to do, I will end up dead first...I printed off the Fibrosure test paper and will present it to the gastro, if he would rather do that and if it is covered by my insurance, that is fine, if he would rather do the liver bx, that is fine too, either way, he is going to do one of them...again with the demanding...but guess what folks? I am on a mission to obtain proper medical care...I don't care who I **** off in the meantime!!! Anybody watch Seinfeld ? When Elaine has a rash and all the doctors blacklist her and she has to go from one to another and make up lies just to get some ointment? That's what I feel like sometimes...
Thanks for listening to all my whining...
Cin
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Avatar_n_tn
Yes, I would be concerned about that nose thing being a basil cell. It doesn't seem right that you have to wait until September to find out.   I cannot believe all the sx you developed after 1 week of treatment.  The rash sounds awful. I hope you will e able to treat again.

Do push for the biopsy.  Can they do it in the office?  I had to schedule mine in the hospital.  I like your style.  Push for what you need!
Kathy
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Avatar_n_tn
Hi, called medicare to see if the fibrosure test was covered, after being on hold and transferd several times was told they would not give out that info. Was told to ask my doctor i told them my gp had never orderd that test before so he didn't know. I offered the cpt codes and was still told sorry wouldn't tell me. Which is worse the doctors or the goverment?....John
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Avatar_f_tn
Those Medicare people hate giving out info...they don't want to be quoted and quite possibly don't know the answer themselves...In NY I go to www.empiremedicare.com click on 'search', type in either the CPT codes, a DX code, whatever, click all 3 boxes for Part A and all 3 boxes for Part B and hit enter. You will then get whatever they have on the subject, it's called an 'LMRP' = Local Medicare Review Policy. They send out  notices to providers on what is covered, not covered, etc. Maybe you can even email them from the site and get an answer which will then be in writing! Even better! The test might be too new in which case they might not even have a policy on it yet...I still wonder if it is FDA approved or on the 'experimental' list or what? Not sure if your state has the same website for Medicare, maybe they call it something besides 'Empire Medicare'  but it's federal so there has to be something out there for you. Let us know!

Oh yeah, the doc did a complete physical, EKG my heart is 'perfect' (why the jumping around and squeezing then...?) I got rx's for Benedryl,2 skin creams, one for my nose inside and out and he says I don't have skin cancer (mystery how he knows w/o a bx...?) Anyway, I'll play his silly little game for now...let you know what the gastro says tomorrow...

Cin

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Avatar_f_tn
I located the CPT codes in the 2005 CPT book, the last 3 have a special coding instructions (don't have the 'CPT assistant' book so not sure). So it appears the codes are valid and not experimental or anything...good news.
Cin
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Avatar_n_tn
Hope that is good news. Thanks for putting so much of your time in this, called labcorp billing but they didn't know they suggested i try medicare again. Will let you know... Thanks again....John
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Avatar_n_tn
Forgot to say that laborp told me if medicare does cover this then they accept what medicare pays as payment in full
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Avatar_f_tn
See, I told you labs are pd at 100%! I say go for it and just refuse to sign anything that says 'Advance Beneficiary Notice' which by the way, has to be VERY specific...it has to say EXACTLY what codes might possibly be denied and for EXACTLY what reason...'blanket' ABN's are not acceptable by Medicare so don't be tricked! Good luck!
Cin
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