> Medicare has paid for the PSA for years, once annually, as long as the
> prescribing physician has had reasonable grounds to believe that the test
> was indicated. Indications included getting up to urinate during the
> night and/or having a slightly enlarged prostate.(who doesn't?)
This is incorrect. Medicare publishes a thick book every year with the
diagnosis codes (ICD-9) of the acceptable indications for the "monitored"
tests. Nocturia and benign prostatic hyperplasia are not acceptable. If
a doctor orders one of the monitored tests without one of the listed
indications, it not only doesn't get paid by Medicare, but the doctor can be
imprisoned for fraud. Starting in 2001, Medicare recipients are entitled to
an annual "screening PSA".
These things change every year, and are very difficult to keep up with.
They also don't pay for a "routine annual exam" this year. You might
disagree with this, but if you think your routine exam was paid for, then
your doctor "fudged" and put down some of your chronic problems as if they
were acute reasons for your visit.
It's crazy... Men deserve a PSA and DRE every year after 40 or so, but that
doesn't mean Medicare will pay for it. Right now the focus is on women's
health care, primarily because they usually make the health care decisions
for the whole family. Ever seen a "Men's Center" at your local hospital?
(There might be a few...).
A couple of us couldn't resist adding some facts to this thread, but no fact
changes the mind of someone believing what they want. It isn't RF in most
cases, guys. Cheerio! 73
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