Guest guest Posted December 4, 2010 Report Share Posted December 4, 2010 Hello All, I have a 13 year old son with autism and epilepsy. During a consultation with a new pediatric neurologist, she recommended that my son get a series of genetic tests done, as she noted that he had some " dysmorphic features " and this raised concerns for a multi-gene disorder. One test in particular, one that is suppose to be the most effective method in detecting chromosomal microdeletions or microduplications, known as " comparative genomic hybridization (CGH) was done on my son but ultimately denied by my insurance company because it was considered " investigational " . The doctors office never gave me the CPT codes to see if my insurance company would pay for it and now there's a possibility that I might be stuck with paying a $3,300 bill! I never thought of checking to see if this was a covered item. I now have to try and appeal the charges with the insurance company and was wondering if anyone else has had a similar experience with the insurance companies denying genetic testing. If so, how were you successful in getting them to pay for it. I have since found out that because of my experience and situation, the doctors office is now providing the CPT codes to their patients so they can check to see if the insurance company will pay for it. Now why didn't they think of doing this for me?!! Thanks, Debbie Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 5, 2010 Report Share Posted December 5, 2010 My children went through the same thing with the cgh which did finally give us the genetic diagnosis but i did have to fight with the insurance and ended up calling our gov and congress. Finally we did get it paid for Genetic Test Hello All, I have a 13 year old son with autism and epilepsy. During a consultation with a new pediatric neurologist, she recommended that my son get a series of genetic tests done, as she noted that he had some " dysmorphic features " and this raised concerns for a multi-gene disorder. One test in particular, one that is suppose to be the most effective method in detecting chromosomal microdeletions or microduplications, known as " comparative genomic hybridization (CGH) was done on my son but ultimately denied by my insurance company because it was considered " investigational " . The doctors office never gave me the CPT codes to see if my insurance company would pay for it and now there's a possibility that I might be stuck with paying a $3,300 bill! I never thought of checking to see if this was a covered item. I now have to try and appeal the charges with the insurance company and was wondering if anyone else has had a similar experience with the insurance companies denying genetic testing. If so, how we Quote Link to comment Share on other sites More sharing options...
Recommended Posts
Join the conversation
You are posting as a guest. If you have an account, sign in now to post with your account.
Note: Your post will require moderator approval before it will be visible.