PET scan denied by insurance, CT scan instead
Who had PET scan or CT scan before their hysterectomy? My DR ordered PET scan but my ins co denied it and would only approve CT scan with contrast and chest X-ray. I'm assuming many of you had the same experience? My surgery is scheduled a week from tomorrow. i think the DR wants to see if the CA spread to pelvic/abdomen area before surgery. Anyone have this experience? The only odd symptoms I'm having is right shoulder, lung and scapula pain.
Thank you to all who have taken the time to share your experience with me and read my questions and good luck to all of you!
Comments
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God bless Google! (BTW, I
God bless Google! (BTW, I have only had a CT. A total of 3. Keep count for yourself as these should not be given like candy)
CT vs PET SCAN
Computed tomography and Positron Emission tomography are both nuclear medicine scans used to detect abnormalities in the different organs of the body. It is an imaging procedure that helps determine appropriate diagnosis and decide necessary treatment for the impending disease. It is commonly used to detect cell abnormalities such as cancer, brain’s unusual functioning, and regions or functions of the heart. Both procedures are comfortable and convenient for patients because it can be done in a single sitting without changing the positions. Furthermore, it is more detailed and accurate leaving no space for miscalculations than any invasive exploratory operations.
Though both are scanners, each has its own distinction from the other.
How CT scan differs from PET scan? Which is better and more economical to use? The benefits and risks involved using both procedures will help the patient make wiser decisions of choosing the more advantageous one.Computerized axial tomography or popularly called CT scan or CAT scan is a computer generated x-ray that allows viewing of the internal body part. It produce cross-section and three dimension imaging of the structures of the body. Not only that it can detect abnormal organs but it can also identify the operation or function of normal body organs. It is also used to direct an instrument inserted inside the body into its precise position or location.
Positron Emission tomography or commonly called PET scan is an imaging test that utilizes a specifically designed camera to view the internal organs of the body. It is done by injecting a radioactive tracer intravenously through the arm. Tracer is a chemical in liquid form that emits positrons that can be identified and modified into a picture to find the problematic organs. PET scan is effectively used in tracing cancer, brain disorders and heart functions. It is also use to determine metabolism of glucose, use of oxygen, and flow of blood throughout the body.
The advantage of PET scan over CT scan is that it can expose the metabolic changes at the cellular level of the body. It can detect developing diseases at an early stage unlike in CT scan, which detection can be a little bit late. However, the picture presented by PET scanning is not as detailed as CT scan due to the fact that the picture in PET scan only exhibits the area where the tracer is positioned.
Summary:
1. PET scan uses a radioactive tracer that emits positron that can be modified to view organs that has problems while CT scan is a computer generated x-ray that can detect normal and abnormal organs of the body.
2. PET has advantage over CT scan because it can show metabolic changes at cellular level important for early disease detection.
3. CT scan is more detailed than PET because PET can only exhibit the areas where the tracer is located.
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What my doctor told meNoTimeForCancer said:God bless Google! (BTW, I
God bless Google! (BTW, I have only had a CT. A total of 3. Keep count for yourself as these should not be given like candy)
CT vs PET SCAN
Computed tomography and Positron Emission tomography are both nuclear medicine scans used to detect abnormalities in the different organs of the body. It is an imaging procedure that helps determine appropriate diagnosis and decide necessary treatment for the impending disease. It is commonly used to detect cell abnormalities such as cancer, brain’s unusual functioning, and regions or functions of the heart. Both procedures are comfortable and convenient for patients because it can be done in a single sitting without changing the positions. Furthermore, it is more detailed and accurate leaving no space for miscalculations than any invasive exploratory operations.
Though both are scanners, each has its own distinction from the other.
How CT scan differs from PET scan? Which is better and more economical to use? The benefits and risks involved using both procedures will help the patient make wiser decisions of choosing the more advantageous one.Computerized axial tomography or popularly called CT scan or CAT scan is a computer generated x-ray that allows viewing of the internal body part. It produce cross-section and three dimension imaging of the structures of the body. Not only that it can detect abnormal organs but it can also identify the operation or function of normal body organs. It is also used to direct an instrument inserted inside the body into its precise position or location.
Positron Emission tomography or commonly called PET scan is an imaging test that utilizes a specifically designed camera to view the internal organs of the body. It is done by injecting a radioactive tracer intravenously through the arm. Tracer is a chemical in liquid form that emits positrons that can be identified and modified into a picture to find the problematic organs. PET scan is effectively used in tracing cancer, brain disorders and heart functions. It is also use to determine metabolism of glucose, use of oxygen, and flow of blood throughout the body.
The advantage of PET scan over CT scan is that it can expose the metabolic changes at the cellular level of the body. It can detect developing diseases at an early stage unlike in CT scan, which detection can be a little bit late. However, the picture presented by PET scanning is not as detailed as CT scan due to the fact that the picture in PET scan only exhibits the area where the tracer is positioned.
Summary:
1. PET scan uses a radioactive tracer that emits positron that can be modified to view organs that has problems while CT scan is a computer generated x-ray that can detect normal and abnormal organs of the body.
2. PET has advantage over CT scan because it can show metabolic changes at cellular level important for early disease detection.
3. CT scan is more detailed than PET because PET can only exhibit the areas where the tracer is located.
When I was told that I was going to have another CT scan, I asked about a PET scan. He told me they could order one but it still won't show up the teeny tiny cancer cells until they are bigger, just like the CT scan. He said the PET scan is looking for a different kind of cancer cell than my kind. I have UPSC. After he explained that, I said, then we might as well do the CT scan. They did a CT scan before my surgery to check to see if the cancer had spread or gone through the uterine wall. It didn't show them that the cancer had already spread. Hope this gives another view.
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CT Scan is usual first scan
I did not get any scans prior to my hysterectomy becasue they didn't know I had cancer. But I have gotten many scans now afterwards. I too was denied a PET scan ordered by my physician denied by the insurance company saying that it wasn't medically necessary.
With insurance companies, most times you need to hae a CT scan first.
Also, please be aware that there is a new scan out called a PET/MRI - but I am not sure how insurance companies are going to handle that. It supposed to be better than a PET/CT and uses less radiation than a CT scan.
Thinking of you on your upcoming surgery.
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PET
i didn't ahve a PET before surgery nor have I had one since. I did inquire with ny oncologist and she said there has to be reason to look beyond the local area before you have PET. also she said there is a lot of radition with a PET and if you do push for it the PET/MRI sounds nice. I have had scans every 6 months post chemo and have asked for MRI's lately and am happier with that. No radiation and I do find that they are more percise with the newer MRI machines
good luck with surgery
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pet scanNoTimeForCancer said:God bless Google! (BTW, I
God bless Google! (BTW, I have only had a CT. A total of 3. Keep count for yourself as these should not be given like candy)
CT vs PET SCAN
Computed tomography and Positron Emission tomography are both nuclear medicine scans used to detect abnormalities in the different organs of the body. It is an imaging procedure that helps determine appropriate diagnosis and decide necessary treatment for the impending disease. It is commonly used to detect cell abnormalities such as cancer, brain’s unusual functioning, and regions or functions of the heart. Both procedures are comfortable and convenient for patients because it can be done in a single sitting without changing the positions. Furthermore, it is more detailed and accurate leaving no space for miscalculations than any invasive exploratory operations.
Though both are scanners, each has its own distinction from the other.
How CT scan differs from PET scan? Which is better and more economical to use? The benefits and risks involved using both procedures will help the patient make wiser decisions of choosing the more advantageous one.Computerized axial tomography or popularly called CT scan or CAT scan is a computer generated x-ray that allows viewing of the internal body part. It produce cross-section and three dimension imaging of the structures of the body. Not only that it can detect abnormal organs but it can also identify the operation or function of normal body organs. It is also used to direct an instrument inserted inside the body into its precise position or location.
Positron Emission tomography or commonly called PET scan is an imaging test that utilizes a specifically designed camera to view the internal organs of the body. It is done by injecting a radioactive tracer intravenously through the arm. Tracer is a chemical in liquid form that emits positrons that can be identified and modified into a picture to find the problematic organs. PET scan is effectively used in tracing cancer, brain disorders and heart functions. It is also use to determine metabolism of glucose, use of oxygen, and flow of blood throughout the body.
The advantage of PET scan over CT scan is that it can expose the metabolic changes at the cellular level of the body. It can detect developing diseases at an early stage unlike in CT scan, which detection can be a little bit late. However, the picture presented by PET scanning is not as detailed as CT scan due to the fact that the picture in PET scan only exhibits the area where the tracer is positioned.
Summary:
1. PET scan uses a radioactive tracer that emits positron that can be modified to view organs that has problems while CT scan is a computer generated x-ray that can detect normal and abnormal organs of the body.
2. PET has advantage over CT scan because it can show metabolic changes at cellular level important for early disease detection.
3. CT scan is more detailed than PET because PET can only exhibit the areas where the tracer is located.
my daughter gets a pet scan every 3 months, she has had mmmt since aug of 2013. its my understanding that a pet scan was better than a catscan because is shows more than the catscan. a petscan shows the brightness of the tumor where the catscan doesn't and when the chemo is working the brightness fades in the petscan where in the catscan it doesn't. this is the impresseion that i had gotten from the doctor.
i also have a question for everyone...is anyone familiar with tumor fever. my daughter sometimes has a low grade fever and that is what the doctor said it was. Please explain what a tumor fever is.
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PET Scan nightmare
Hi, Judemo,
I didn't have a PET or CAT Scan prior to my hysterectomy last October, 2013, but did have a PET Scan several weeks later to determine if I had cancer spread. It was fortunately negative. However, my insurance company gave me a runaround with paying it. First it was approved, then denied, then approved, then denied and then-after I threatened to file a complaint with the State of Florida's Insurance Commission- approved. Six months after I had the PET Scan my insurance company finally paid for it. We women with UPSC are not treated the same way by insurance companies as women who have ovarian epithelial cancer, yet these cancers may be identical. They both certainly act the same and are equally aggressive. I also had a CAT Scan last April after all my chemo treatment was done and that was negative, too. My insurance company paid for the CAT Scan without a problem. I have stage 3A UPSC. I have heard that by the time a PET Scan or a CAT Scan picks up on a metastasis-the size of a tumor- the patient probably would probably be having symptoms of a problem, but this is not always true. There are some women here with stage 4 disease who have never had a symptom of cancer initially or even after a recurrence. I had slight post-menapausal bleeding on one day only and have not had any other symptoms.
It would be great if there was a test that definitively could detect microscopic individual cancer cells in a person's body, but we don't have that technology yet.
Keep us posted, Judemo. I wish you the very best outcome with your upcoming surgery.
Cathy
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Tumor feverdenise05121953 said:pet scan
my daughter gets a pet scan every 3 months, she has had mmmt since aug of 2013. its my understanding that a pet scan was better than a catscan because is shows more than the catscan. a petscan shows the brightness of the tumor where the catscan doesn't and when the chemo is working the brightness fades in the petscan where in the catscan it doesn't. this is the impresseion that i had gotten from the doctor.
i also have a question for everyone...is anyone familiar with tumor fever. my daughter sometimes has a low grade fever and that is what the doctor said it was. Please explain what a tumor fever is.
One of my bffs had kidney cancer. She had been running fevers for months with no known dx. She finally ended up in the hospital (I don't remember why, but she had a fever that wouldn't go away) and they did I think an MRI (maybe a CT scan) that showed the tumor in her kidney. Apparently if tumor cells start getting necrotic (sometimes this is not a good thing) the body reacts and develops a fever. Or something like that. You can google tumor fever. I think it's not an uncommon thing that happens when one has cancer. Or something like that. I had never heard of it until my friend had it. I googled it and learned about it.
Suzanne
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Great info! Thanks so much!NoTimeForCancer said:God bless Google! (BTW, I
God bless Google! (BTW, I have only had a CT. A total of 3. Keep count for yourself as these should not be given like candy)
CT vs PET SCAN
Computed tomography and Positron Emission tomography are both nuclear medicine scans used to detect abnormalities in the different organs of the body. It is an imaging procedure that helps determine appropriate diagnosis and decide necessary treatment for the impending disease. It is commonly used to detect cell abnormalities such as cancer, brain’s unusual functioning, and regions or functions of the heart. Both procedures are comfortable and convenient for patients because it can be done in a single sitting without changing the positions. Furthermore, it is more detailed and accurate leaving no space for miscalculations than any invasive exploratory operations.
Though both are scanners, each has its own distinction from the other.
How CT scan differs from PET scan? Which is better and more economical to use? The benefits and risks involved using both procedures will help the patient make wiser decisions of choosing the more advantageous one.Computerized axial tomography or popularly called CT scan or CAT scan is a computer generated x-ray that allows viewing of the internal body part. It produce cross-section and three dimension imaging of the structures of the body. Not only that it can detect abnormal organs but it can also identify the operation or function of normal body organs. It is also used to direct an instrument inserted inside the body into its precise position or location.
Positron Emission tomography or commonly called PET scan is an imaging test that utilizes a specifically designed camera to view the internal organs of the body. It is done by injecting a radioactive tracer intravenously through the arm. Tracer is a chemical in liquid form that emits positrons that can be identified and modified into a picture to find the problematic organs. PET scan is effectively used in tracing cancer, brain disorders and heart functions. It is also use to determine metabolism of glucose, use of oxygen, and flow of blood throughout the body.
The advantage of PET scan over CT scan is that it can expose the metabolic changes at the cellular level of the body. It can detect developing diseases at an early stage unlike in CT scan, which detection can be a little bit late. However, the picture presented by PET scanning is not as detailed as CT scan due to the fact that the picture in PET scan only exhibits the area where the tracer is positioned.
Summary:
1. PET scan uses a radioactive tracer that emits positron that can be modified to view organs that has problems while CT scan is a computer generated x-ray that can detect normal and abnormal organs of the body.
2. PET has advantage over CT scan because it can show metabolic changes at cellular level important for early disease detection.
3. CT scan is more detailed than PET because PET can only exhibit the areas where the tracer is located.
Thank you for the great info!
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Thank you Kaleena!Kaleena said:CT Scan is usual first scan
I did not get any scans prior to my hysterectomy becasue they didn't know I had cancer. But I have gotten many scans now afterwards. I too was denied a PET scan ordered by my physician denied by the insurance company saying that it wasn't medically necessary.
With insurance companies, most times you need to hae a CT scan first.
Also, please be aware that there is a new scan out called a PET/MRI - but I am not sure how insurance companies are going to handle that. It supposed to be better than a PET/CT and uses less radiation than a CT scan.
Thinking of you on your upcoming surgery.
Thank you Kaleena!!
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Thank you Hybridspirits!Hybridspirits said:PET
i didn't ahve a PET before surgery nor have I had one since. I did inquire with ny oncologist and she said there has to be reason to look beyond the local area before you have PET. also she said there is a lot of radition with a PET and if you do push for it the PET/MRI sounds nice. I have had scans every 6 months post chemo and have asked for MRI's lately and am happier with that. No radiation and I do find that they are more percise with the newer MRI machines
good luck with surgery
Thank you all so much!
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Thank you Abbycat!Abbycat2 said:PET Scan nightmare
Hi, Judemo,
I didn't have a PET or CAT Scan prior to my hysterectomy last October, 2013, but did have a PET Scan several weeks later to determine if I had cancer spread. It was fortunately negative. However, my insurance company gave me a runaround with paying it. First it was approved, then denied, then approved, then denied and then-after I threatened to file a complaint with the State of Florida's Insurance Commission- approved. Six months after I had the PET Scan my insurance company finally paid for it. We women with UPSC are not treated the same way by insurance companies as women who have ovarian epithelial cancer, yet these cancers may be identical. They both certainly act the same and are equally aggressive. I also had a CAT Scan last April after all my chemo treatment was done and that was negative, too. My insurance company paid for the CAT Scan without a problem. I have stage 3A UPSC. I have heard that by the time a PET Scan or a CAT Scan picks up on a metastasis-the size of a tumor- the patient probably would probably be having symptoms of a problem, but this is not always true. There are some women here with stage 4 disease who have never had a symptom of cancer initially or even after a recurrence. I had slight post-menapausal bleeding on one day only and have not had any other symptoms.
It would be great if there was a test that definitively could detect microscopic individual cancer cells in a person's body, but we don't have that technology yet.
Keep us posted, Judemo. I wish you the very best outcome with your upcoming surgery.
Cathy
I tell ya, you all are wonderful and so helpful & supportive! Thanks again for sharing all of your experiences and knowledge...it really helps! Also, thanks for the best wishes!
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I have a history of breast
I have a history of breast cancer and just recently had my blood work show that I have positive circulating tumor cells. It is my understanding that this means I have cancer cells that have shed from a tumor and are in my bloodstream. I had a PET scan denied by the insurance and they are recommending a CT scan. My worry is that maybe something won't show up on the CT because it's not big enough and I will go on not treating an early metastic cancer. Anyone have any thoughts on this?
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The main reason to get a PET/CT is that they do a better job of showing cancers greater than 1 cm. sorry about the underlining, can't get it to stop
The main reason insurance companies prefer CT over PET is the PET is way more expensive. It is also much, much safer than a straight ct, using only a minimum of radiation.
537 × 334 - aboutcancer.comOnce your doctor is aware that you know the difference between the two scans, you might have a more honest conversation. UPSC shows up the same as any other cancer. They all are showing the amount of activity of the cancer cells.I simply googled pet scan vs cat scan cancer to get these two photos. There were hundreds more.Picture at the left is a PET scan showing colon cancer that has spread from the pelvis region to the liver. PET scans are much more sensitive than CT scans ...","md":"/search?hl\u003den\u0026tbs\u003dsbi:AMhZZit7ZhJx4JM2OP7cIrH5VIn4pd0FeiWXlfFgyUEs-vqJHu35kbXp0jb4XFgnM59cZxpJjST4IGPPa0RmsJoRBzPmBfXKepY4UrcjXsmbgi3r9uieogu7CDtpktFpaZvPJ_179T8KR8tEPg0nYLrfqBbsQttFIy55cDYpGsFrrDlcHeqqovtZ_1FinpLu65Qq5NOJNm8Pk9ZhuuHahGJ2HTgWrLjJwbhQpi02T36IWXrlLJ8uEWp8B-XXkXneQBTauDjL3QbI_1VwLFsGFTFmqg8ZmIeFJkHmA","tw":285,"pt":"PET Scans in Cancer Cases","fn":"pet_neck_node_relapse_sah_sep_2006.jpg","oh":334}0 -
PET scans
I have had lots of CT scans and a couple PET scans. If they see something in the CT that needs further clarification they have me do a PET scan. Apparently my doctors knew what codes or whatever it took to get the insurance company to comply.
My two-cents:
I hate it that others are being hassled by their insurance companies - these scanning decisions need to be made by physician experts, not insurance companies! They have totally different goals/motivations, one considers the health side of the patient, the other the business side of their company.
Best,
Susan
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PET scan denied
My doctor ordered a PET scan after my recurrence and it was denied by my insurance. I paid for it myself. It was a lot, but at least I "only" had to pay the insurance company rate. I had Aetna at the time and Googled Aetna's rules on PET scans. They only approve it for certain kinds of cancer. They approve it for cervical and ovarian cancer, but not endometrial. They even stated specifically that they wouldn't cover it for clear cell endometrial cancer, which is the kind I have.
Sue
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Scan necessary or not
Due to have hysterectomy on 6/30 -Dr ordered CAT scan which so far insurance co is denying- diagnosis is grade 1 endometrial type cancer- upon questioning her as to what the cat scan would be looking for she said my most recent Pap test showed no evidence of cancer spread to my cervix etc. and now she is saying it is not 100% vital . Being that this is my first cancer issue I just don't know what to think - I am on board with everything the dr wants me to do but on the one hand first saying she wants scan then saying not that vital just making me crazy plus reading a lot on the internet frightening me also
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A scan prior to surgery cansmudgie123 said:Scan necessary or not
Due to have hysterectomy on 6/30 -Dr ordered CAT scan which so far insurance co is denying- diagnosis is grade 1 endometrial type cancer- upon questioning her as to what the cat scan would be looking for she said my most recent Pap test showed no evidence of cancer spread to my cervix etc. and now she is saying it is not 100% vital . Being that this is my first cancer issue I just don't know what to think - I am on board with everything the dr wants me to do but on the one hand first saying she wants scan then saying not that vital just making me crazy plus reading a lot on the internet frightening me also
A scan prior to surgery can hellp do a better surgery instead of having to go back in if they find something. I had a hysterectomy and after the hysterectomy they found cancer so I had to go have another surgery one month later.
It is difficult though with insurance companies. I believe if you doctor writes a letter for the necessity of it, the denial can be overturned.
My best to you
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smudgie123
I had a little bit of bleeding, then a couple of ultrasounds (internal and external) when my GYN found I had a large endometrial polyp. I got referred to a gyn/onc at another hospital. I was set up for robotic surgery. Before the surgery, my gyn/onc ordered a CT scan, which I got done at a different hospital where I worked. I saw the report before the day of surgery and called the gyn/onc because the cancer was in more places than the gyn/onc had thought it was. Unfortunately, I only got to talk to some office employees (he's a very busy man). I asked them to relay the message to him, but I don't think they did. The day of the surgery, my gyn/onc finally reviewed my CT scan report from the other hospital, and when he walked into the room where I was waiting for my surgery, he told me my cancer was much too extensive to have robotic surgery. It turned out I had stage IVb, the highest stage. My cancer had spread from the uterus to both ovaries (but the tubes were cancer free). I had a cake-like cancer formation in my omentum and a spread to my small intestine. I also had gallstones. My sister, a nurse who was there with me, requested my gyn/onc take the gallbladder out at the same time so I wouldn't need a second surgery. He called in a gastroenterologist that day who removed my gallbladder and my appendix during my cancer surgery. Thank God my gyn/onc asked for the CT scan report before the surgery. If he hadn't, I might not be alive and cancer-free today (AND free of gallbladder complications). I've survived 5 years and one month today since my surgery, pretty remarkable considering UPSC has a 9% survival rate for stage IV.
I would highly recommend having a CT scan before surgery, even if you have to pay for it yourself. It could save your life!
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CT scansmudgie123 said:Scan necessary or not
Due to have hysterectomy on 6/30 -Dr ordered CAT scan which so far insurance co is denying- diagnosis is grade 1 endometrial type cancer- upon questioning her as to what the cat scan would be looking for she said my most recent Pap test showed no evidence of cancer spread to my cervix etc. and now she is saying it is not 100% vital . Being that this is my first cancer issue I just don't know what to think - I am on board with everything the dr wants me to do but on the one hand first saying she wants scan then saying not that vital just making me crazy plus reading a lot on the internet frightening me also
i did not have a scan until after my hysterectomy. My initial biopsy was clear cell cancer, so because of its agressiveness , a given that everything would be removed - uterus, Fallopian tubes, many lymph nodes, cervix, ovaries, and lymphatic tubes. The biopsies from the robotic surgery changed the diagnosis to UPSC. I had a scan prior to chemo so oncologist could confirm that cancer was 100% gone and that chemo was just to make sure and mitigate chance of recurrence. CT scan showed spots on my liver so I had an MRI. The spots were benign hemangiomas.
0
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