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Thallium Stress Test Denied

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Posted 6/13/2009 2:31 AM (GMT 0)
Hi

My wife had an EKG that said "possible anterior infrac"

The Dr ordered a Thallium Stress Test.

BCBS would only approve the cheaper exercise stress test (non nuclear)

She did the cheaper exercise stress test and it came in normal.

She is 58 years old. Should we push for the thallium stress test to detect any possible blockages.

Harry    

Posted 6/17/2009 12:00 AM (GMT 0)
If the regular treadmill test came back normal, it's unlikely that your wife has a serious problem with her coronary arteries. A Thallium stress test might not be necessary, besides the only 100% accurate test is a cardiac catheterization, but it would be unwarranted if the standard threadmill test is normal. EKG results are not infallible, she might have never had an infarct.
Posted 6/17/2009 12:53 PM (GMT 0)
Hi

Thanks Cello.

At my work a thallium stress test is part of management's annual physical exam.....symptoms or not.

The Dr orders a thallium stress test and insurance denys it.....it don't seem right.

I don't like to take chances with heart health.

Harry
Posted 6/23/2009 12:15 AM (GMT 0)
Insurance companies know how to make and not to lose money. They know that preventive medicine saves money and increases their profit, if routine Thallium Stress Tests would be more effective as a preventive test, they wouldn't deny it. Believe me, they have done their homework.

Posted 6/23/2009 12:39 AM (GMT 0)
Something else, it's true that the Thallium test might be more accurate, however for most screening purposes the regular threadmill test might be sufficient. Besides, the doctor does not make his diagnosis based only in the stress test alone, he uses other tests, the history, the symptoms and the physical examination. If it's a case in which the doctor strongly suspects something wrong with the coronary arteries, he will insists in doing the Thallium test, if on the contrary, the doctor only needs a screening test for a case that doesn't look like a coronary obstruction, he will order the regular threadmill. The insurance companies have made extensive and meticulous studies to determine that the extra cost of the Thallium test does not increase sustantially the number of correct diagnoses, therefore they consider it "not cost effective". Many times, insurance companies know more about the effectiviness of tests, medicines and treatments than the medical profession, because they collect information by the millions.
Posted 6/23/2009 12:46 AM (GMT 0)
Another controversial test is the PSA that checks the health of the prostate, extensive statistical studies have shown that the PSA test does not reduce the number of deaths from proastate cancer. I wonder if some insurance companies put some restrictions in the use of this test, because the know that it will not reduce the number of fatal cases of prostate cancer, which is their only concern.
Posted 6/30/2009 12:20 PM (GMT 0)

Hi

Well .... I had a Thallium Stress Test and they found 2 small spots of concern.

The Dr did not order a cath because I had no pain during the test plus my kidney function is little off. One month later I had a heart attack. Well... then I got caths and 3 stents over a 2 week period.

Yep, medicine is not a perfect science.

Harry

Posted 6/30/2009 7:26 PM (GMT 0)
Medicine could be more aggresive if lawyers weren't lurking for possible malpractice cases. Your doctor was aware of the "spots of concern" but was probably afraid to order a cardiac cath. due to your abnormal kidney function, because if something had gone wrong he could have been sued for malpractice.
Posted 6/30/2009 10:29 PM (GMT 0)

Hi

I hear you. Maybe that's why the bills came to $150K+ for my heart attack treatment and stenting.

Harry

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