Is a dexa every 2 years enough?

Posted by hopefulheart @hopefulheart, May 21 4:16pm

My doctor suggested that a Dexa scan every 2 years is what he uses to monitor Evinity then followed by reclast
I asked about blood turnover markers to see if meds are working along the way
He said he doesn’t use those
Time for a new doctor????

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@elisabeth007

i have found that its best to get such information in writing. Do you know how to use the text function of Medicare. i would suggest being very specific and naming the specific tests and asking what the specific documentation from your dr needs to say.

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@elisabeth007, I don't think I know. Is that different than the chat feature?

Thanks.

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You can always request the test and offer to pay for it yourself. One other option (if you live in a place that has one) is to go to DexaFit. This gives you a “whole body” T-score, which I have found to parallel my DEXA scores. My scans are $150, but I buy a package of 4, which reduces the cost to about $80 a piece. Also tells you about muscle mass and fat mass, which is equally useful info, since we are trying to stay strong, and maintain our balance, and muscle pulling on bone promotes growth. I get these 3-4 times a year. I personally think once a year for a DEXA is perfectly reasonable and would allow you to better understand what is going on with your bones. Insurance usually only pays for every other year.

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@elisabeth007

Do you know how to check if your insurance company defines those tests as “medically necessary” for your condition? Usually, there is an electronic tool on the insurance portal that allows patients to evaluate the cost (co pays and/or whether certain tests and/or procedures are covered). Just out of curiosity, has your new dr confirmed that he or she believes those tests are medically necessary?

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He has not
Because he doesn’t use them at all

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@mlwh

You can always request the test and offer to pay for it yourself. One other option (if you live in a place that has one) is to go to DexaFit. This gives you a “whole body” T-score, which I have found to parallel my DEXA scores. My scans are $150, but I buy a package of 4, which reduces the cost to about $80 a piece. Also tells you about muscle mass and fat mass, which is equally useful info, since we are trying to stay strong, and maintain our balance, and muscle pulling on bone promotes growth. I get these 3-4 times a year. I personally think once a year for a DEXA is perfectly reasonable and would allow you to better understand what is going on with your bones. Insurance usually only pays for every other year.

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@mlwh, never heard of it and, of course, none in Denver, but here is a link to locations:
https://www.dexafit.com/dexafit-store-mapper

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i don’t even know if the telephone customer service people know what bone marker tests are—-i didn’t until i heard about them i this venue.

Mt doctors don’t rely on them. Could you help me understand why you believe they are more valid than Dexa scores that have been relied upon for many decades

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i think your dr is doing what the majority of drs are doing. Is mayo routinely using bone marker tests?

the research i read on that was very fuzzy if fda approval has been granted. Does anyone know?

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@elisabeth007

for the first time, i have a claim that needs to be appealed on Medicare and the directions i’m reading seem to say i’m the one who needs to write the appeal

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Yes, you submit the appeal, but you should get some supporting documentation from your dr if the appeal is based on medical issues (test not justified, too soon to repeat test, etc).

The last time I submitted an appeal of Medicare's denial of some blood tests, I included a short letter from my dr explaining the condition he was evaluating and that was sufficient to get the appeal granted.

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@babs10

@elisabeth007, I don't think I know. Is that different than the chat feature?

Thanks.

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If you use Medicare's chat, you can save a copy of the discussion.

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@elisabeth007

i don’t even know if the telephone customer service people know what bone marker tests are—-i didn’t until i heard about them i this venue.

Mt doctors don’t rely on them. Could you help me understand why you believe they are more valid than Dexa scores that have been relied upon for many decades

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@elisabeth007, others will chime in, I'm sure, but for me, these bone marker tests are not more valid than DXA scores - that is comparing apples and oranges.

If you get the baseline blood tests before you start meds, you can retest in 3-4 months (and beyond) and the results of those blood tests will inform you as to whether or not the medication is actually doing what it's supposed to be doing. I'd hate to spend 2 years on Forteo or Evenity etc. to find out at the end that they didn't work. If they aren't working, there is an opportunity to change the treatment plan.

My first MD would not order them because he said the results would not change his plan and that made zero sense to me.

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@hardingv

If you use Medicare's chat, you can save a copy of the discussion.

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@hardingv, yes, I was just wondering if chat is different than the text feature that @elisabeth007 mentioned in terms of information that is available.

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