Initial blood tests to ask for ?
Hello...
I just had a dexa indicating osteoporosis, and will discuss soon with my PCP. I had a CBC done earlier this summer. I have seen CTX as an important test. I am wondering if I should ask for that on my discussion visit, or anything else, for that matter. Endo initial visit is not for a few months.
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Am I the only one who considers it weird that we have to know what tests are needed and ask for them? Isn't that the responsibility of the medical professionals?
@normahorn many endos don't do the CTX or P1NP. That is why I mentioned those first! The other tests we have all mentioned are pretty standard, as you say!
Can you explain more what CTX and P1NP tests are? Also what we should do if they are not in the correct range?
P1NP for bone formation/osteoblast activity
And parathyroid blood test ...I forgot the abbreviation for that but Dr will know....
PTH
and sometimes CTX is more important than P1NP, for instance on bisphosphonates
Thx windyshores - actually it was easily accessible via Google search which led me also to some articles on the subject.
I was thinking of CTX as a baseline - I'm not on any meds at all.
Overall it is going to take me a while to just get familiar with all the various terms and what's important to look at.
Yes baseline is important and should be fasting and done at the same early morning time ( 7-9 is good), according to Dr. McCormick.
Question about the CTX and P1NP tests: I asked my MD to order these and he did. I have looked into whether Medicare and my secondary (Anthem) covers them and have found conflicting information. Does anyone know for sure? Do the tests have to be coded in a specific way in order for them to be considered necessary?
Thanks.
Hi Everyone,
I asked my endocrinologist to please order the CTX and P1NP blood tests to get a baseline before starting Forteo (which he did). Soon thereafter, I read on this site (love this site) that the tests aren't always covered by Medicare. I called Medicare and they said they will be covered if the MD considers them "medically necessary."
I followed up and he wrote back:
"I generally don't order these tests because I don't think they generally change how I am treating you. I do think they are reasonable to do however and likely would be covered by insurance. The question is, will the results change our management? I don't think so, which is why I don't usually order them." (Isn't the whole point of the tests to be able to gauge the success and make changes if the meds aren't working, but I digress).
I followed up with: "Thank you. Especially for the first year of treatment I want to have a baseline and then a follow up to see how I am doing on the meds. Would you be willing to deem them medically necessary under these circumstances?"
He wrote back: "I can and have ordered these tests but it's not up to me if they are covered by your insurance."
Anyway, would you take your chances? I don't know how much the tests cost but I'm already going to be paying $1920 per month for the Forteo so anything sounds hard, but I do want the baseline. All input and suggestions welcome.