@prarysky - Thank you. Yes, silicone. I spoke with the Admin in my previous MD's practice and learned a few things. First, "recommended" is not enough justification for insurance coverage. Second, ICD-10 codes keep changing. Third, they receive more requests for documentation to justify claims than they used to. Fourth, although they have had issues with denials (with companies such as United Health), not with Medicare. That tells me I should expect Medicare will cover the exams. She gave me the ICD and CPT codes they use. They are different than what the current provider uses.
My current provider's system is huge (a giant in the industry). There is one number and one email address for patient relations - for all practices, not just oncology. I get someone different every time I call. The Admin in the current practice told me yesterday his "knowledge around this complicated claim is unfortunately limited." He is working to find someone else for me to contact.* If he thinks an annual exam is complicated, how in the world can he handle truly complicate issues?
(*UPDATE: while writing this the manager who handles billing escalations called. She confirmed they used different codes. After a lengthy conversation she will attempt to resubmit the claim using the codes I obtained. If that doesn't work, she will cancel/forgive the outstanding charge. Although I appreciate the concession, I said I will not return for another exam unless this has a permanent resolution.)
Stay tuned for more updates. Thanks to all for your support!