LymeNet Flash: Spect scan studies... insurance denial

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»	LymeNet Flash » Questions and Discussion » Medical Questions » Spect scan studies... insurance denial

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Topic: Spect scan studies... insurance denial

Brent
Member
Member # 12797

posted

My insurance company, Blue Cross of Philadelphia, denied a Spect scan ordered by my neurologist,Dr.R in NJ.

My MRI showed " a small linear T2/Flair hyperintensity in the left peritrigonal white matter is seen which does not enhance and is nonspecific"

Dr. R is appealing this ruling.

Can anyone point me to any studies to help me in getting this spect scan approved?

Thank You,

[ 09. March 2008, 10:43 PM: Message edited by: Brent ]

Posts: 12 | From USA | Registered: Aug 2007 | IP: Logged |

tailz
Unregistered

posted

I had a SPECT scan, and I don't think it's 'proof' of Lyme anyway, so why radiate your head just to satisfy your curiosity?

I regret having mine. I'm electrosensitive, and as soon as she hit the 'on' button, I spent the next 45 minutes trying not to pee myself - no lie.

Of course, I can't really tell any doctor this because they will tell me that this is impossible. Yep.

IP: Logged |

timaca
Frequent Contributor (1K+ posts)
Member # 6911

posted

Check your insurance policy (which means read it). If spect scans are not specifically mentioned as being not covered...then they should be covered.

Your insurance company is not allowed to dictate your medical care...unless something is specifically stated as so in your policy.

Timaca

Posts: 2872 | From above 7,000 ft in a pine forest | Registered: Feb 2005 | IP: Logged |

Brent
Member
Member # 12797

posted

Thanks for your replies.

tailz.. You are correct that the Spect is not for diagnosing Lyme disease.
I already know I have Lyme. I've been on high dose abx for 8 months.

My symptoms are mostly neurological. My doc thinks I might have Neuroborreliosis.

timaca..I will read my policy. I didn't think of that. Thanks

Posts: 12 | From USA | Registered: Aug 2007 | IP: Logged |

adamm
Unregistered

posted

Hmmm...

doesn't sound like you're seeing what we refer to as

a Lyme-Literate MD, or LLMD. Lyme is a clinical diagnosis, and

it virtually always causes CNS problems. You should

post in seeking a doctor and try to find a practitioner who belongs

to ILADS, the International Lyme and Associated Diseases

Society. One of them wouldn't require a brain scan to

determine whether or not to give you a certain treatment.

I do hope you get things worked out with your insurance,

though.

IP: Logged |

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