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codythedog avatar

P1NP and CTX

Osteoporosis & Bone Health | Last Active: Apr 26 4:45pm | Replies (37)

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Profile picture for babs10 @babs10

Tonight, I was told by a nurse that Medicare will no longer pay for the CTX blood turnover marker test if you are not taking medication (but they will pay for the P1NP).

It was suggested that if you want to get the CTX, ask the clinic to make it "self pay" and ask them not to bill Medicare. My impression was that private insurance will still cover CTX.

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Replies to "Tonight, I was told by a nurse that Medicare will no longer pay for the CTX..."

@babs10 How would Medicare even know this? Labcorp submits a claim, and Medicare says "let's find this person's Part D plan and see if they're taking any medication"?? I don't see how.

@babs10 If what your nurse told you is true about Medicare, that is lousy news. It also lends support to those doctors who do not believe in its value. Thank you for the heads-up. We seldom hear about Medicare coverage changes until payment for a particular service is denied.