radioembolizaiton

sledhead
sledhead Member Posts: 11

I have had tests (MRI, Ultrasound, & biopsy) to proceed with radioembolization for liver mets. My provider is currently running it by the insurance co. (BCBS) for approval. Has anyone else had to deal with insurance companies for approval with this proceedure? If so, was it approved & how long did the process take? It seems to be a sort of an "off label" procedure for rcc.

Comments

  • Limelife50
    Limelife50 Member Posts: 476
    Hmmm

    Could you might mean Radio Frequency Ablation if i am wrong then sorry

  • sledhead
    sledhead Member Posts: 11

    Hmmm

    Could you might mean Radio Frequency Ablation if i am wrong then sorry

    yttrium 90

    Radioembolization uses microscopic spheres filled with radiation called yttrium 90 & is injected into the hepatic artery to the tumors. The spheres cutoff the blood supply to the tumors as well as penetrate them with radiation. Radiofrequency Ablation uses a probe to in a sense burn the tumor(s). Radioembolization can be used for whole liver treatment regardless of tumor size where as rfa has a limit of around  3cm I believe. The problem with radioembolization is that insurance companies view it as off-labe for rcc & can deny coverage. I was wondering if anyone else has had any experience with this treatment for rcc mets & insurance coverage.

  • Good luck with BCBS.  Like

    Good luck with BCBS.  Like most other health insurance companies, they are a nightmare to deal with.  One thing I have learned is to call and ask twice before getting any procedure done, keeping track of the time and the name of the rep I talked with and to make notes.  After approving my partial neprhectomy last July, they reversed course on me and told me I could not get the procedure done by the doctor that they said was in my network.  It took a threat of a lawsuit and calling a state assemblywoman who made a call to BCBS to get my procedure approved.

    Lesson learned--get everything approved in advance.

  • sledhead
    sledhead Member Posts: 11
    Yttrium 90

    Has anyone had the yttrium 90 for rcc mets?

  • Limelife50
    Limelife50 Member Posts: 476
    sledhead said:

    yttrium 90

    Radioembolization uses microscopic spheres filled with radiation called yttrium 90 & is injected into the hepatic artery to the tumors. The spheres cutoff the blood supply to the tumors as well as penetrate them with radiation. Radiofrequency Ablation uses a probe to in a sense burn the tumor(s). Radioembolization can be used for whole liver treatment regardless of tumor size where as rfa has a limit of around  3cm I believe. The problem with radioembolization is that insurance companies view it as off-labe for rcc & can deny coverage. I was wondering if anyone else has had any experience with this treatment for rcc mets & insurance coverage.

    okay

    Thanks

  • Jojo61
    Jojo61 Member Posts: 1,309 Member
    sledhead said:

    Yttrium 90

    Has anyone had the yttrium 90 for rcc mets?

    Good luck to you, Sledhead. I

    Good luck to you, Sledhead. I hope the procedure goes well for you.

    Hugs

    Jojo