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It's me again

betina61's picture
betina61
Posts: 644
Joined: Aug 2006

I just received a phone call from my Dr. assistant, telling me that the insurance only approved the pet scan, and depending on the result they will approve the ct scan, I would like to know after finishing treatment what scans where done on you guys, if both pet and ct scan or only one, please let me know.

AveriRN's picture
AveriRN
Posts: 61
Joined: Aug 2004

Hi, I was dx in 03 st4 and have had ct scans every 3 mos since then, I have had pet scans as well, but only 4 pet scans in 3 yrs and my docs not very quick to jump to pet, say there are many times it has given false positive or negative but in my instance, when I had beast reappear, my pet "lit" up like a candle. I don't think they do pet scans as freq. as ct.

Averi

FRANTIC
Posts: 106
Joined: Nov 2004

I had petscan/catscan combo done. As the radioligist stated the petscan/catscan combined
does from the head to the thighs. I still had to drink contrast and a special diet of no carbohydrates the night before. Your friend Fran

chynabear's picture
chynabear
Posts: 483
Joined: Jul 2005

Are you sure they didn't approve the CT and not the PET?

My insurance had a fit over 2 PET scans I already had done based on them telling my doctor's office that, "no approval was needed" and then later denied them. I fought and won, but from here on out they will only approve a PET in the case of something showing on the CT. I am 2 years and 4 months survivor. First 2 years post dx, I started CT/PET every 3 months (until PET denied). For 3rd year, I will have CT every 4 months. In 4th year it will be CT every 6 months. That's the plan, anyhow. I also have bloodwork done every 3-4 months.

It is ridiculous how the insurance companies work. I have seen the bill for the CT, the PET and the CT/PET. They are all within $200 billed to insurance, but insurance (mine anyway) doesn't want to pay for the PET or CT/PET unless something shows up.

Plus, according to my onc, this is the standard follow-up screening for Stage III.

Sorry for long note, this is a sore subject with me lol. Hope this helps in any way.

Tricia

Betsydoglover's picture
Betsydoglover
Posts: 1254
Joined: Jul 2005

Betina -

Like Tricia I'll bet it the PET they are balking at (much more expensive than CT).

I am Stage IV and go thru this every time (which is quite frequently). About every third time the insurance company rejects the PET saying pre-approval is required (it is not). I call - it gets resolved. But that alone gives them a few weeks without having to pay. Every single time they take a couple of weeks and then kick it out saying a "statement of medical necessity" is needed. Even though I see that when I look at my insurance online, they wait around a month to actually ask the radiologist for this info. Then normally they "accidentally" process it as if he is "out of network" - which he is not. It goes on and on and on and then they eventually pay. They are still "processing" my PET from Oct 2!

This is one of my hot buttons too!!!

Betsy (meanwhile my oncologist says this is the standard of care for a Stage IV like me with the results I have had!)

hopefulone
Posts: 1048
Joined: Jan 2007

hi.. my husband had both ct and pet. and is having ct's again on monday . The pet was about a month and half ago. The first ct was 2 mos ago.Now more ct's. They each tell a "different side" of the story.

betina61's picture
betina61
Posts: 644
Joined: Aug 2006

thank you all of you for your response, it appears,that they want to delay the ct scan until we have the results of the pet, but anyway I will call the insurance on Monday because I want to have all this done a.s.a.p. I will keep you posted, and thanks aga.in

shmurciakova's picture
shmurciakova
Posts: 910
Joined: Dec 2002

Yeah, that is wierd because normally a PET is done to confirm whether or not something that shows up on a CT is cancer (or not).
The thing is, whatever shows up on the CT needs to be at least 1cm in size or else the PET scans can give false negative readings.
Hmmmm.......well, good luck with sorting this out!
-Susan

MCarr's picture
MCarr
Posts: 20
Joined: Feb 2007

I was dx in Nov.'99 and did a Ptscan and a Ctscan as a basis 3 months after last treatment. Then went to Ctscans every 3 months and Ptscans once a year. After reccurence I stayed on the 3 month schedule for Ctscans, but did a PTscan every 6 months. Last year (4 years after reccurence) we went to Ctscans every 6 months and Ptscans once a year. Now I am only doing scans if I feel the need: new symptoms or piece of mind. I have been told that Ptscans do have some false positives, but I would rather have a false positive than miss a small tumor. My Ctscans missed my reccurrent tumor, but it did light up the Ptscan. The Ctscan would have probally showed it on the next scan, but that would have been 3 months later.

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