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Old 05-03-2009, 11:49 PM   #16
harrie
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Join Date: Mar 2007
Location: Hilo, Hawaii
Posts: 1,867
Well Folks, I appealled and lost. My ins will not pay for annual DEXA, but will only pay for once every 2 yrs. This is what was said:
"...scientific evidence does not support improved health outcomes with yearly monitering of bone mineral density in a patient on aromatase inhibitors being treated with a bisphosphonate, nor is it the standard of care.
......in review of your case, the Committee discussed the change to the policy regarding the use of annual DEXA scans for patients treated with aromatase inhibitors. It was noted that, because of the potential of bone loss, annual scans were done until research and a formal policy review concluded that given the nature of the bone loss and the specificity and reliability of DEXA scan, scans done more frequently than 24 months were not useful to determine the course of treatment.

So I am stuck with the +$500 DEXA.
__________________
*** 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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