Re: Saline Sup. medical code

[Guest guest]

No idea what the code is, but I will say this: few, if any, of the names of the

tests I had done during my diagnosis corresponded to reality in any way!

The one that stands out in my memory the most is the code for my AVS - it

translated to something like " adrenal tumor embolization " and for a couple days

I was really freaked out that what I was booked for in the hospital was not what

I had signed on for

>

> quick question. since this group is VERY knowledgeable about the tests for

PA.... Does anyone know the medical order code for the saline suppression?

> i called the insurance company tonight to make sure if this had to be

approved, that it is indeed approved. the lady said she had never heard of

anything like the saline suppression. so it might not need approval but i should

call my doctor or the hospital and get the code. and check with them first.

>

> i am a little nervous now. i was really counting on this happening on

Wednesday...

>

> i have a feeling the hospital that i am going to doesn't really do this type

of test often,considering my doctor himself handled the paper work and phones

calls.

>

>

> 38 yrs

> aldo 30 (?-28)

> renin .38 (.25-5.89)

> ratio 78.9 (.9-28.9)

> Nifedipine 30 mg

> Bystolic 5mg

> CT scan normal

> Saline suppression june 27th!

> K- (3.2 thru 4.0) 3.2 was when i was training for half marathon.... 4.0 was

with very little running for a few months...

> K-only low if I start to run or exercise vigorously. so i have shortened

mileage and slowed pace a great deal to compensate. (a work in progress)

> BP avg 140-160's/80-100's on a good day

>

[Guest guest]

Try 80408 "Evoctive Suppression Test" No guarantee but you can see for yourself on page 7 here:

https://provider.medica.com/C14/ClaimPolicies/Document%20Library/Laboratory_Services_Policy.pdf

>> quick question. since this group is VERY knowledgeable about the tests for PA.... Does anyone know the medical order code for the saline suppression? > i called the insurance company tonight to make sure if this had to be approved, that it is indeed approved. the lady said she had never heard of anything like the saline suppression. so it might not need approval but i should call my doctor or the hospital and get the code. and check with them first.> > i am a little nervous now. i was really counting on this happening on Wednesday...> > i have a feeling the hospital that i am going to doesn't really do this type of test often,considering my doctor himself handled the paper work and phones calls.> > > 38 yrs> aldo 30 (?-28)> renin .38 (.25-5.89)> ratio 78.9 (.9-28.9)> Nifedipine 30 mg> Bystolic 5mg> CT scan normal> Saline suppression june 27th! > K- (3.2 thru 4.0) 3.2 was when i was training for half marathon.... 4.0 was with very little running for a few months...> K-only low if I start to run or exercise vigorously. so i have shortened mileage and slowed pace a great deal to compensate. (a work in progress)> BP avg 140-160's/80-100's on a good day >

[Guest guest]

Oh, you've got Cigna too. FWIW, they were a dream to work with throughout my

entire diagnosis and surgery - covered everything almost 100%, never questioned

or denied anything, and the only thing that needed pre-approval was the surgery

itself.

> >

> > quick question. since this group is VERY knowledgeable about the tests for

PA.... Does anyone know the medical order code for the saline suppression?

> > i called the insurance company tonight to make sure if this had to be

approved, that it is indeed approved. the lady said she had never heard of

anything like the saline suppression. so it might not need approval but i should

call my doctor or the hospital and get the code. and check with them first.

> >

> > i am a little nervous now. i was really counting on this happening on

Wednesday...

> >

> > i have a feeling the hospital that i am going to doesn't really do this type

of test often,considering my doctor himself handled the paper work and phones

calls.

> >

> >

> > 38 yrs

> > aldo 30 (?-28)

> > renin .38 (.25-5.89)

> > ratio 78.9 (.9-28.9)

> > Nifedipine 30 mg

> > Bystolic 5mg

> > CT scan normal

> > Saline suppression june 27th!

> > K- (3.2 thru 4.0) 3.2 was when i was training for half marathon.... 4.0 was

with very little running for a few months...

> > K-only low if I start to run or exercise vigorously. so i have shortened

mileage and slowed pace a great deal to compensate. (a work in progress)

> > BP avg 140-160's/80-100's on a good day

> >

>

[Guest guest]

JC

> >> > quick question. since this group is VERY knowledgeable about the tests for PA.... Does anyone know the medical order code for the saline suppression? > > i called the insurance company tonight to make sure if this had to be approved, that it is indeed approved. the lady said she had never heard of anything like the saline suppression. so it might not need approval but i should call my doctor or the hospital and get the code. and check with them first.> > > > i am a little nervous now. i was really counting on this happening on Wednesday...> > > > i have a feeling the hospital that i am going to doesn't really do this type of test often,considering my doctor himself handled the paper work and phones calls.> > > > > > 38 yrs> > aldo 30 (?-28)> > renin .38 (.25-5.89)> > ratio 78.9 (.9-28.9)> > Nifedipine 30 mg> > Bystolic 5mg> > CT scan normal> > Saline suppression june 27th! > > K- (3.2 thru 4.0) 3.2 was when i was training for half marathon.... 4.0 was with very little running for a few months...> > K-only low if I start to run or exercise vigorously. so i have shortened mileage and slowed pace a great deal to compensate. (a work in progress)> > BP avg 140-160's/80-100's on a good day > >>

[Guest guest]

, your comment made me smile, you should have seen my IR when he

was getting ready for me to sign the release and his nurse was

explaining the AVS. When I indicated I understood the process she asked

if I had done it before. I explained I almost got there until I found

out the IR had only done 6 in 15 years. Dr. Chang perked up and asked

what Idid. I said, " I'm here " . His answer, " Smart Man, we are going

get along just fine! " I was Dr. Chang's 3d AVS that day!

I met with a phsychritist the other day in the VA's walk-in clinic to

discuss finding a new doctor. I explained that I needed someone who

understood how excess cortisol might be effecting my PTSD & depression

and my concern that my reduced testosterone (androgen) might be

exacerbating the issue in the area of the CYP11B2/CYP11B1 genes pumping

even more cortisol to interact with the sertonin and causing me to

remain in constant state of stress! He wasn't offended, in fact he

said, " You really know your $hit! I'm going to refer you to a doctor

from DHMC who practices at the VA 1 day week. He has been treating mood

disorders for years. " (DHMC is the largest hospital in the area and

associated with Dartmouth College.) So I may not have to start off at

ground zero with this one!

Any doctor that takes umbrage with you being an informed PTN is probably

not your best choice, IMHO! (of course you better know your $hit!)

Don't get me wrong, I'm happy to work with a " young " doctor who is

learning but they better include me as part of the team! Most respect

the amount of time I have spent researching this in the last 16 months

or so and I often give them the same references I supply here. (Many of

the " young " doctors really appreciate that!)

> >

> > quick question. since this group is VERY knowledgeable about the

tests for PA.... Does anyone know the medical order code for the saline

suppression?

> > i called the insurance company tonight to make sure if this had to

be approved, that it is indeed approved. the lady said she had never

heard of anything like the saline suppression. so it might not need

approval but i should call my doctor or the hospital and get the code.

and check with them first.

> >

> > i am a little nervous now. i was really counting on this happening

on Wednesday...

> >

> > i have a feeling the hospital that i am going to doesn't really do

this type of test often,considering my doctor himself handled the paper

work and phones calls.

> >

> >

> > 38 yrs

> > aldo 30 (?-28)

> > renin .38 (.25-5.89)

> > ratio 78.9

> (.9-28.9)

> > Nifedipine 30 mg

> > Bystolic 5mg

> > CT scan normal

> > Saline suppression june 27th!

> > K- (3.2 thru 4.0) 3.2 was when i was training for half marathon....

4.0 was with very little running for a few months...

> > K-only low if I start to run or exercise vigorously. so i have

shortened mileage and slowed pace a great deal to compensate. (a work in

progress)

> > BP avg 140-160's/80-100's on a good day

> >

>

[Guest guest]

Did they do other tests besides the MRI?

> >>> > >

> >>> > > quick question. since this group is VERY knowledgeable about the

> >>> tests for PA.... Does anyone know the medical order code for the saline

> >>> suppression?

> >>> > > i called the insurance company tonight to make sure if this had to

> >>> be approved, that it is indeed approved. the lady said she had never

> >>> heard of anything like the saline suppression. so it might not need

> >>> approval but i should call my doctor or the hospital and get the code.

> >>> and check with them first.

> >>> > >

> >>> > > i am a little nervous now. i was really counting on this happening

> >>> on Wednesday...

> >>> > >

> >>> > > i have a feeling the hospital that i am going to doesn't really do

> >>> this type of test often,considering my doctor himself handled the paper

> >>> work and phones calls.

> >>> > >

> >>> > >

> >>> > > 38 yrs

> >>> > > aldo 30 (?-28)

> >>> > > renin .38 (.25-5.89)

> >>> > > ratio 78.9

> >>> > (.9-28.9)

> >>> > > Nifedipine 30 mg

> >>> > > Bystolic 5mg

> >>> > > CT scan normal

> >>> > > Saline suppression june 27th!

> >>> > > K- (3.2 thru 4.0) 3.2 was when i was training for half marathon....

> >>> 4.0 was with very little running for a few months...

> >>> > > K-only low if I start to run or exercise vigorously. so i have

> >>> shortened mileage and slowed pace a great deal to compensate. (a work in

> >>> progress)

> >>> > > BP avg 140-160's/80-100's on a good day

> >>> > >

> >>> >

> >>>

> >>

> >>

> >

>

[Guest guest]

From pubmed

Cardiovasc Res. 1997 Jul;35(1):138-47.

Fibrosis of atria and great vessels in response to angiotensin II or aldosterone

infusion.

Sun Y, Ramires FJ, Weber KT.

Source

Department of Internal Medicine, University of Missouri Health Sciences Center,

Columbia 65212, USA.

Abstract

OBJECTIVE:

Myocardial fibrosis, associated with increased expression of angiotensin

converting enzyme (ACE) and bradykinin (BK) receptor binding at sites of tissue

repair, accompanies chronic elevations in circulating angiotensin II (AngII)

and/or aldosterone (ALDO) that simulate chronic cardiac failure. A role for

increased ventricular wall stress, associated with arterial hypertension, that

can accompany such neurohormonal activation when ventricular function is not

compromised, has been held responsible for this structural remodeling. To

address this proposition, we monitored morphology of right and left atria and

pulmonary artery, where stress is not increased, and compared these structures

with hypertensive aorta.

METHODS:

Experimental groups included: (1) unoperated and untreated controls; (2) intact

rats receiving AngII (9 micrograms/h) for 2 weeks and which causes arterial

hypertension; (3) uninephrectomized control rats on a high sodium diet for 6

weeks; and (4) uninephrectomized rats receiving ALDO (0.75 micrograms/h) and a

high sodium diet for 6 weeks and which results in gradual onset arterial

hypertension. Fibrosis was identified by light microscopy in sections stained

with collagen specific picrosirius red, while ACE, AngII and BK receptors

binding were localized and quantitated by in vitro autoradiography using

125I-351A, 125I[sar1,Ile8]AngII, and 125I[Tyr8]BK, respectively. AngII receptor

subtype was defined by the presence of excess AT1 (losartan) or AT2 (PD123177)

receptor antagonists, respectively.

RESULTS:

With either AngII or ALDO administration, and compared to controls, we found:

(1) microscopic scarring that replaced lost myocytes in both left and right

atria; (2) an increase in adventitial collagen of both pulmonary artery and

aorta (perivascular fibrosis); (3) markedly increased ACE binding at fibrous

tissue sites in both atria and great vessels; (4) unchanged atrial and great

vessel AT1 receptor binding; and (5) significantly increased BK receptor binding

at sites of atrial and perivascular fibrosis.

CONCLUSIONS:

Thus, the appearance of atrial fibrosis and perivascular fibrosis of aorta and

pulmonary artery, together with associated increase in ACE and BK receptor

binding, in rats receiving AngII or ALDO suggests these responses are not

related to altered ventricular wall stress or arterial hypertension, but rather

to these effector hormones of the circulating renin-angiotensin-aldosterone

system. Local BK, regulated by ACE found in fibrous tissue and BK receptor

binding may play a role in structural remodeling of atria and great vessels in

these rat models that stimulate chronic cardiac failure.

> >>>>> > >

> >>>>> > > quick question. since this group is VERY knowledgeable about the

> >>>>> tests for PA.... Does anyone know the medical order code for the

> >>>>> saline

> >>>>> suppression?

> >>>>> > > i called the insurance company tonight to make sure if this had to

> >>>>> be approved, that it is indeed approved. the lady said she had never

> >>>>> heard of anything like the saline suppression. so it might not need

> >>>>> approval but i should call my doctor or the hospital and get the code.

> >>>>> and check with them first.

> >>>>> > >

> >>>>> > > i am a little nervous now. i was really counting on this happening

> >>>>> on Wednesday...

> >>>>> > >

> >>>>> > > i have a feeling the hospital that i am going to doesn't really do

> >>>>> this type of test often,considering my doctor himself handled the

> >>>>> paper

> >>>>> work and phones calls.

> >>>>> > >

> >>>>> > >

> >>>>> > > 38 yrs

> >>>>> > > aldo 30 (?-28)

> >>>>> > > renin .38 (.25-5.89)

> >>>>> > > ratio 78.9

> >>>>> > (.9-28.9)

> >>>>> > > Nifedipine 30 mg

> >>>>> > > Bystolic 5mg

> >>>>> > > CT scan normal

> >>>>> > > Saline suppression june 27th!

> >>>>> > > K- (3.2 thru 4.0) 3.2 was when i was training for half

> >>>>> marathon....

> >>>>> 4.0 was with very little running for a few months...

> >>>>> > > K-only low if I start to run or exercise vigorously. so i have

> >>>>> shortened mileage and slowed pace a great deal to compensate. (a

> >>>>> work in

> >>>>> progress)

> >>>>> > > BP avg 140-160's/80-100's on a good day

> >>>>> > >

> >>>>> >

> >>>>>

> >>>>

> >>>>

> >>

> >>

> >>

> >

> >

>