Does anybody know?

[fochoa97]

Hello warriors, does anybody know if c11 choline pet ct scan is covered by insurance? Zytiga didn't work for me..... my last psa test was on march 20th @ 43.2 i been taking it for almost 3 months and psa keeps climbing, i have an appointment with Dr Kwon at Mayo Cinic in Minnesota. My insurance is BCBS of Texas. Your imput will be greatly appreciated.

[Tall_Allen]

Call your insurance to get pre-approval. I don't know why you'd want a C-11 PET scan - it's outmoded. The Axumin scan is much better, but Kwon may ask for the C-11 scan anyway so that Mayo can make back their investment on it. At any rate, at your PSA, didn't a bone scan/CT reveal any metastases?

[fochoa97 in reply to Tall_Allen]

Last bone scan was clean (dec 2017) but mets to aortic nodes according to sodium floride pet ct scan....

[Tall_Allen in reply to fochoa97]

The sodium fluoride PET only shows bone mets, but the CT part apparently showed enlarged lymph nodes. An Axumin scan should reveal whether those lymph nodes are enlarged due to cancer or because of other reasons. Assuming you have no bone mets on the Axumin scan, and if you've never had pelvic radiation before, I think you should consider whole pelvic radiation.

[fochoa97 in reply to Tall_Allen]

Thank you so very much for your reply Tall_Allen, i had 44 sessions of imrt and last ct shows negative results on prostate and pelvic nodes but psa keeps climbing.... on sodium fluoride scan report shows aortic nodes involvement.... i am currently on lupron zytiga and prednisone, no pain yet, thats why im seeking for another opinion.. dr Kwon seems like a great option what do you think?

[Tall_Allen in reply to fochoa97]

Did the 44 sessions of IMRT you had include the pelvic LNs or was that just the prostate (with a margin around it)?

[fochoa97 in reply to Tall_Allen]

Prlvic nodes also got irradiated... i just got my psa results from yesterday and psa dropped from 43.7 to 9.1... great news to me mr Tall_Allen!!!

[Tall_Allen in reply to fochoa97]

Congratulations - that is great news! I guess you had a delayed reaction - I hope it continues.

[fochoa97 in reply to Tall_Allen]

Thank you for replying Tall_Allen I'll be calling my insurance tomorrow morning , i hope they approve the scan....

[Daddysdaughter]

I know Medicare medical covers it my father had 4 scans at mayo.. hopefully it does! Dr. Kwon is a character, make sure he gives you a CD of his 🎶

[fochoa97 in reply to Daddysdaughter]

Thank you so much for your reply Daddysdaughter ill be calling my insurance to find out... I'll ask for a cd if i get to go to see dr Kwon..

[Don1157]

I had BC&BS from Kansas and went to Decatur Illinois for the pet scan. They paid like they usually pay, about 30%. But then there is co-insurance, and since it was out of State, and likely out of network; we got a bill for the rest. Going to call to get that lowered for sure. Pretty outrageous because if I did not have insurance they would taken about what insurance paid.

[Don1157 in reply to Don1157]

Let me add, make sure your MO or urologist gets approval for the C11 Choline, because they did not pre authorize that! Jerks!

[Grumpyswife]

It is dismaying to see that Mayo isn’t using the Axumin scans. I would like my husband to see Dr Kwon again but would want the Axumin scan.

[dmartell]

BCBS of MA would not pre-authorize the C11 PET scan through Mayo in Rochester. Only allowed an MRI of the pelvic area for my husband.

[fochoa97 in reply to dmartell]

Than you dmartell, yes mi insurance didn't pre approve the scan .....