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DiscussionNebulizer and saline treatment with daily exercise
MAC & Bronchiectasis | Last Active: Jan 8 9:46pm | Replies (52)Comment receiving replies
Replies to "Does insurance cover this? Or does NJH bill? Thank you."
Here's the dreaded answer "It depends."
If your doctor orders the sputum culture, he can write specific orders to send it to NJH, where they can not only do the AFB (fast) test for NTM/MAC, but also the culture, colony count and sensitivity testing. Few local labs are set up to handle this with the expertise of NJH, so it is a legitimate order. NJH then bills your insurance company, or if your doctor or clinic has a standing arrangement with them, it is billed through their regular lab billing process, and coded as an "outside service."
From there, it is an insurance issue, and depends on your carrier and policy. I have Medicare as my primary coverage and BCBS through my previous employer to take up the slack. My bill is 100% covered. My daughter's employer is self-insured, so she pays the $20 or $25 lab copay.
So if you want it done through NJH, step 1 is to see the doc, discuss & get the order. Step 2 is to check your insurance coverage or discuss the testing/billing process with your clinic. Step 3 is to submit the sample as directed by the doctor either to their lab to be shipped, or direct to NJH.
Have you been having regular cultures done?