Medical Insurance: DEXA

Since I am taking prednisone for anti-rejection, my nephrologist asked me to get a DEXA scan to check my bone density. I read online that taking prednisone long-term has many side effects, including osteoporosis.

The National Osteoporosis Foundation (NOF) recommends obtaining a DEXA if a patient is on prednisone or an equivalent of 5 mg/day or greater for 3 or more months.

https://www.rheumatologyadvisor.com/home/decision-support-in-medicine/rheumatology/steroid-induced-osteoporosis/#:~:text=The%20National%20Osteoporosis%20Foundation%20(NOF,for%203%20or%20more%20months.

So today I called the St. Joseph outpatient pavilion to schedule an appointment. I get most of my scans done in the second-floor radiology department. After being put on hold for five minutes, I was told the diagnosis code provided on the order was not covered by Medicare. The code was Z94.0: kidney transplant status. The scheduler said Medicare needs a code like osteoprosis, high calcium, or something like that. I Just called my nephrologist’s office to let them know and hopefully they can change the order.

I have had many medical procedures and appointments in the past seven years, and I am pretty satisfied overall. The worst part of the experience was insurance. I have both Medicare and Blue Shield. I pay almost $600 per month for Medicare, and it only covers 80% and does not cover medication. My work insurance does not have any premiums and usually pays for most things. By having two insurances, I end up paying more, not counting Medicare premiums. Recently, Medicare rejected a claim due to me not meeting my deductible. Without Medicare, my work insurance would pay for it, but since it is secondary, Medicare gets to decide how much work can pay and it is less than if I did not have Medicare. WTF?