@hello1234 ,

Did your transplant nephrologist or your home neph submit the prior authorization? The first 3 years will be covered as “routine surveillance” . After that time, it’ll be covered as “for-cause”. Our insurance company covers the test only if there is “clinical evidence of active allograft injury or suspected acute rejection”. So the doctor has to submit recent lab trends showing kidney function decline, a signed letter of medical necessity and an explicit statement that impacts treatment plan.
Just curious, what would be hubby’s reason for doing this test? Suspicion of acute rejection because patient is not meeting the required trough level associated with his txplant drugs? Asking becuz I want insurance to cover test. Note: not sure if home neph would agree to this!