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Do you get CEA (Carcinoembryonic Antigen) Blood test for lung cancer?
Lung Cancer | Last Active: Apr 23 2:38pm | Replies (15)Comment receiving replies
Husband’s oncologist ordered Guardant Reveal blood test, without his knowledge, just done as part of p a weekly blood draw. We received a notice thar insurance company has denied payment, and that cost is $5000 (!), but they are appealing. He always signs paperwork prior to blood draw, has never been charged, and no one pointed this out to him! I thought a Medicare ABN had to be explained/signed prior to tests ordered but Medicare deems not medically necessary due to pt’s condition (dx) so that the patient might responsible for payment. Very disturbing!
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@abob, I agree that he should have been presented with information on the potential for denial. The companies that perform these types of tests are familiar with dealing with denials, so this isn't over yet, and unfortunately denials are common.
When I was first diagnosed, I was obviously stage IV and my husband's insurance still denied the claim. The performing lab contacted me, I signed an authorization to allow them to appeal the denial on my behalf. I never heard from them again. Either it got paid, or the company waived the charge.
Be patient, it may take some time to work out, but hopefully you won't be left with a bill.
(Link to the CMS page with biomarker info: https://www.cms.gov/medicare-coverage-database/view/ncd.aspx?NCDId=372)
In some cases these test results can significantly alter treatment plans. Are his results back yet? Were there any significant findings from the test?