Why did insurance deny my brain scan?

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minxie
minxie Member Posts: 484
edited May 2016 in Employment, Insurance, and Other Financial Issues

A lung mass was found on a CAT scan last week and since then I've consulted with my oncologist and a thoracic surgeon. The thoracic surgeon ordered a PET and a brain scan. I did the PET yesterday but the imaging center called me today to tell me Cigna denied the brain scan. What could be their rationale for this?

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  • pajim
    pajim Member Posts: 2,785
    edited May 2016

    It may be that they require specific symptoms to authorize a brain scan.

    Or the surgeon needs to justify it somehow. Sometimes they reject it but will approve if you appeal. They just want to know the doctor isn't doing it on a knee-jerk basis.

    I have bone mets but have never had a brain scan. PETs yes, but the doc has never seen a reason to do a brain scan.

    You may not need one. I realize it would probably give you peace of mind, but if you don't have double vision or feel totally demented or have major headaches, you likely don't have to worry. The ladies on the Brain Mets thread could tell you what to watch out for.

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