Oct 06, 2012 - 12:18 pm
Hey all ...looking for some ammo here (and opinions if anyone thinks it's fair or not fair, I want to be sure I am being reasonable).
Here's my history in a nutshell.
Oct 20, 2011 of head and chest reveals mass at base of tongue with mets to one lymph node
Nov 16, 2011 PET scan of whole body to determine stage III base of tongue and one lymph node
Nov 20, 2011 tx began - 35 rads and Erbitux
Jan, 20, 2012 last rad, no more Erbitux
May 6, 2012 PET reveals good results, slight uptick of heat in vocal cords, some heat at base of tongue still, but team of docs feels it is just rad residual, not disease residual.
August 6, 2012 CT w/ contrast of head and neck, oncologist cofirms NED (I asked if we could do lungs and brain as well, oncologist said no, base of skull and mid-chest only)
November 8, 2012 suppose to have PET of eyes to thighs, Insurance company says no because it's a "surveillance " scan and they do not cover those. Treatment yes, surveillance not covered. The way I read the denial letter it seems to me NO PET or any surveillance will be covered in the future, but I may be wrong on that...never easy to read those letters.
Of course the letter is signed by an MD (head docotor in charge on their end).
My treatment center immediately appealed the decision, and within 1 week denial was upheld, so I was told my Oncologist would schedule another CT scan in November instead of PET (I assume the CT will be of head and neck, nothing else).