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Questions about RT and U.S. Medicare
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myrightfoot 

myrightfoot 
Questions about RT and U.S. Medicare

Does anyone know precisely what the Medicare position is regarding RT for DD and LD? Does anyone know precisely what evidence was submitted to Medicare in appeals and what the response was? It would seem useful if those who have appealed could post this.

flojo 

flojo 
Re: Questions about RT and U.S. Medicare

I don't know, but Loma Linda is working closely with me to try to nail down that information. I gave LLUMC all of Medicare Explanation of Benefits relative to my RT at Scripps. They reviewed those carefully and think that Medicare will pay. Medicare paid for the big ticket item, the actual RT, but they did not pay for the radiologist's mapping and oversight, etc.. Makes no sense.

Dr. Katerelos is prepared to write documentation needed if an appeal is necessary. I will soon know, as I had my #7 or 7 treatments today. You can send me a Private Message if you have specific question now.

callie 

callie 
Re: Questions about RT and U.S. Medicare

The first Dr. I saw about RT for Dupuytren's said that Medicare jurisdiction was divided into six, or seven, areas and they are not consistent in ruling what will be covered. The office that I am working with now told me that Medicare would not cover RT for Dupuytren's. The bad thing is that you don't know if they will cover it, or not, until after the procedure is finished. I was quoted a price of $11,000 to $13,000 for the procedure.

myrightfoot 

myrightfoot 
Re: Questions about RT and U.S. Medicare

Thanks again, callie and flojo. Amazing that you can't at least apply for a prior approval from Medicare and find out one way or the other! Knock wood, I guess it's good if they at least cover the RT itself. I wonder what they'd do about LD.

UHOH 

UHOH 
Re: Questions about RT and U.S. Medicare

Hi Everyone,

My name is Annie, aka Uhoh. I am 64 and diagnosed with DC several days ago. What a fabulous resource this is. I have been reading it non-stop for hours. I have never posted on any forum before so I hope i am doing this correctly.

I am thinking my DC is very active as it went from a bump I could feel under the skin to something about 3/8" and very visible in a matter of 6 weeks. I noticed the top join on my pinky finger is crooked, although that may have been that way for awhile. I am hoping I am a candidate for RT.

Where to go for treatment is my next question. That is partially dependent on if and where Medicare will cover the treatment. I am very interested if you have any additional and/or any specific information as to where Medicare will cover the procedure.



Many thanks,

annie

callie 

callie 
Re: Questions about RT and U.S. Medicare

Firstly, your age is in your favor. Many (perhaps most) people who first notice Dupuytren's at your age can live with Dupuytren's for the rest of their lives without any procedure. A large percentage do not have a significant contraction.

Secondly, Dupuytren's generally is not painful and easy to live with. Medicare may, or may not, cover RT. The problem with Medicare is that they won't tell you until after the procedure whether, or not, they will cover it.

Larry 

Larry 
Re: Questions about RT and U.S. Medicare

The most important aspect is to get experienced doctors to examine Your hands AND feet ....
and the to find a good radiotherapy facility ! All the best Larry

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