I have been on Casodex and Eligard since June 2022. My PSA was still high after RALP so I had a GA-68 PSMA PET Scan done which revealed one 11mm tumor in the Left pelvic Lymph Nodes and one 7mm Tumor in the Right pelvic Lymph Nodes. Those were the only 2 hot spots in my body. My Dr. scheduled me for IMRT (38 rounds total) which started August 16th, and he wanted to find the baseline for my bone density before the IMRT started and since I'm on ADT so he ordered a DEXA scan.
When I was checked in to get the DEXA Scan, the Office where I had the scan done had a hard time finding the proper ICD code for the scan. They finally found something they said would work and sent me to have the scan done. They also had me sign a form saying Medicare may not pay for the test and I may be responsible for it. I'm on traditional Medicare and Tricare for life. Medicare denied the claim for the DEXA scan which was $500 and for the Dr. visit for the DEXA scan which was $135. Since Medicare denied the claim, Tricare has also denied the claim. I have been searching the internet for the proper ICD codes to use for a DEXA scan for males with prostate cancer but can't find any.
Has anybody else had a DEXA scan that was paid for by Medicare?
Weird. First of all, a dexascan should cost 1/2 that much. Secondly I have now had 2 covered my Medicare. My dexascan was done at a hospital. Do you use Dr Vinnie Boombatz?
Thanks for the Information. I live in Pensacola, Florida and had the scan done at a Baptist Hospital facility. Do you by chance know what ICD code was used? I'm probably going to have to call billing at the hospital and find out what happened and if they will resubmit. If I have the proper ICD code I can tell them what to use. I run into a lot of providers that submit the wrong codes and I have to find them. I'm seeing Dr. Timothy Brand Urology Oncology and Dr. James Adams Radiation Oncology. Both at Baptist Hospital. Baptist Hospital has a partnership with the Mayo Clinic.