Quote from denial letter
Rebecca, this is what they wrote:
" According to HMSA's medical policy for Bone (Mineral) Density Studies, follow-up studies performed more frequently than once every two years is limited to individuals on glucocorticoid (steroid) therapy equivalent to 5.0 mg or more or prednisone per day for more than three months, with precertificaton. In addition, bone density studies performed less than 24 months do not adequately reflect bone turnover, do not improve health outcomes, or decrease the incidence of fractures."
A friend of mine (same ins) is also on Femara and has annual DEXAs taken and the insurance covers. She also has osteopenia.
Maryanne
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*** MARYANNE *** aka HARRIECANARIE
1993: right side DCIS, lumpectomy, rads
1999: left side DCIS, lumpectomy, rads, tamoxifen
2006:
BRCA 2 positive
Stage I, invasive DCIS (6mm x 5mm)
Grade: intermediate
sentinal node biopsy: neg
HER2/neu amplified 4.7
ER+/PR+
TOPO II neg
Oncotype dx 20
Bilat mastectomy with DIEP flap reconstruction
oophorectomy
2007:
6 cycles TCH (taxotere, carboplatin, herceptin)
finished 1 yr herceptin 05/07
Arimidex, stopped after almost 1 yr
Femara
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