Found Reason no action after cath

A few days ago I posted I was fed up with having cath's done, basicly the reason was they informed me there were still blockages and couple new ones, yet they did nothing, no stenting.. Apparently Medicare and my supplemental Insurance will not cover any stenting or by pass procedure unless there is dam near total blockage, this to me is crazy but the way it was explained to me yesterday when i finally went off in doctors office, has any one else ran into this issue?

4 Comments

Strange

by SMITTY - 2009-10-15 07:10:53

Hello Jim,

I think somebody may not be telling you the truth. At least I never heard of such rules from Medicare and I have had my share of caths and stents where the artery was only partially blocked or there was not enough blockage to warrant a stent.

As for stenting a blocked artery, that can't be done. There must be enough of an opening in the artery to insert a balloon so it can be inflated to press the plaque against the walls of the artery and then the stent is inserted.

Refusing to pay for bypass surgery unless you have a totally blocked artery, that is illogical. A blocked artery is one of the major causes of heart attacks. It would be in Medicare and the insurance companies best interest to let the doctor do the bypass before you have a heart attack. I've had bypass surgery where three partially blocked arteries were bypassed.

I'm not saying you were not told exactly what you have told us but my experience with caths, stents and bypass surgery has certainly been different and so far as I know the rules have not changed that much.

Smitty

Thats what they told me

by Jim From Pa - 2009-10-15 08:10:27

That is exactly what they told me, there must be a certin amount of blockage, i did not say total blockage, i have one at 60 percent and another about 70, plus smaller ones, they, all them, do not meet the guidelines, they say, i am inquiring with my medicare and supplemental insurance at this time

Zombie

by ElectricFrank - 2009-10-16 08:10:10

If you are having fun that's the way to go. Life is a terminal illness anyway. Let then get in there and start messing with stents and you may have extended your life span. (in a nursing home after a stroke)..

frank

How about this?

by ElectricFrank - 2009-10-16 12:10:54

The % blockage is not an exact measurement and depends on the judgment of the doc doing the cath. I don't mean lying about it. Wait a couple of months and then see a different doc. A little discrete checking around my turn up one one who tends to take less risks with the patients life.

frank

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