When our Uro orders a PSA test -

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erbob
Regular Member


Date Joined Jan 2010
Total Posts : 281
   Posted 12/12/2010 9:50 AM (GMT -6)   
My Brachytherapy procedure took place last May so I am about to get another PSA test to make certain all is well. I have the Uro's PSA order in hand and will take it to the local hospital for the test. Although I have insurance in addition to Medicare, I still like to know what the charges will be so I called the Hospital and asked their normal price for the test. Although the Dr.'s order merely shows "PSA" the folks who draw the blood told me that there are three different tests with three different prices. PSA #3 costs $196, PSA screening costs $123 and PSA "total" costs $113. OK, how does the hospital determine which of the three tests will apply for me if the order merely shows PSA???????????
Finally, if the VA is chosen to do a PSA test, does anyone here know how often the VA will allow a PSA test in a given year? Perhaps two per calendar year???

proscapt
Veteran Member


Date Joined Aug 2010
Total Posts : 644
   Posted 12/12/2010 1:42 PM (GMT -6)   
erbob - I don't know anything about the VA process, but the lab I go to has two psa tests, one, the screening, is the basic test for people not yet treated, that is not super-sensitive. The other is for people who have already been treated is more sensitive and and expensive.

Just a guess in your case: "total" just gives one number for total PSA. "screening" may give free % and total PSA, "test #3" is probably the one you want. Just a guess.

If you want to be safe, have the hospital give you the specific lab requisition paperwork they use, which should have three different boxes to check for the different tests; give it to your uro and ask the uro to check off the particular test he meant to order. That puts the uro in the driver's seat for ordering the right test, which is where the responsibility should be, I think.

fulltlt
Regular Member


Date Joined Nov 2010
Total Posts : 264
   Posted 12/12/2010 1:51 PM (GMT -6)   
From my last EOB when I had the last PSA test done:

RUSH COPLEY MEDICAL CENTER
Outpatient Lab Test 10-12-10 238.00 238.00
Laboratory Services 10-12-10 45.00 45.00
Totals $283.00 $283.00
Totals $283.00 $0.00 $283.00
Discount (ADP) -$166.97
Deductions
Total Benefits Approved $116.03
Amount You May Owe Provider $0.00


and here's a second EOB from that same date:

Service Date Amount Billed Not Covered Covered
PATHOLOGY ASSOCS OF AURORA LLC
Rout Lab Test 10-12-10 22.00 17.50 (1) 4.50
Totals $22.00 $17.50 $4.50
Totals $22.00 $17.50 $4.50
Participating Provider Option (PPO Reduction) -$17.50
Total Benefits Approved $4.50
Amount You May Owe Provider $0.00
age 57 2/2010
PSA 8.2 2/2010
biopsy 2/2010 - 2 of 8 left & 2 of 8 right positive, Gleason 3+4=7
attended support group - advised to get a second opinion
second opinion on pathology from Johns Hopkins 4+4=8
PSA 15 4/2010
5 weeks IMRT 4/2010-6/2010 at Copley Hospital in Aurora, IL
91 palladium 103 seeds 7/2010 at Chicago Prostate Center, Westmont, IL
PSA 3.97 10/2010
no ED or incontinence

Post Edited (fulltlt) : 12/12/2010 1:00:38 PM (GMT-7)


erbob
Regular Member


Date Joined Jan 2010
Total Posts : 281
   Posted 12/12/2010 2:45 PM (GMT -6)   
proscapt, that's a good idea. I'll drop it on my Uro to decide exactly which of the three PSA tests I should have.
fulltlt, I noted that you had some of your stuff done in the Aurora area. I used to live over in Naperville for over 25 years and am very familiar with the area.
Also had my brachytherapy done over at Chicago Prostate Ctr, Westmont in May of this year and am very happy with the results so far. Shoot me an email if you have time and don't mind sending one.
Still hope someone will comment on frequency of PSA's that the VA will normally authorize/allow.
Bob, located in Southern Colorado
Retired railroader
Born 1936
Dx Jan 2010, Volume 51.345
Gleason 3+4=7, second opinion 4+3=7 (Don't know which to believe)
Brachytherapy May 26, 2010
No catheters
First PSA three months after seeds 0.12
Doing just fine.

Post Edited (erbob) : 12/12/2010 1:54:11 PM (GMT-7)


erbob
Regular Member


Date Joined Jan 2010
Total Posts : 281
   Posted 12/13/2010 7:13 PM (GMT -6)   
Thought sure this thread would generate a LOT more interest since we are all subject to PSA tests.
Asked my Uro today, through his receptionist, which of the three PSA tests I should get at our local hospital. The receptionist relayed his response to me which was,
just tell the folks at the hospital that you want a PSA test. Sounds like he might not be too interested in my case. Guess I was just putting a little too much faith in his interest in me and my PC although he was the one who performed the biopsy and gave me the PC Dx....... mad
Bob, located in Southern Colorado
Retired railroader
Born 1936
Dx Jan 2010, Volume 51.345
Gleason 3+4=7, second opinion 4+3=7 (Don't know which to believe)
Brachytherapy May 26, 2010
No catheters
First PSA three months after seeds 0.12
Doing just fine.

goodlife
Veteran Member


Date Joined May 2009
Total Posts : 2691
   Posted 12/13/2010 7:21 PM (GMT -6)   
I am very specific about what type of PSA I want done. The standard PSA is also known as dagnostic, and if the doctor checks PSA, that is the one I will get. It is accurate to .1.

I have always had two decimal precsionb, and that is what I am tracking. So the doctor has to mark Ultrasensitive. Actually, the doctor only makes a note for the exit person to order a PSA. I make sure she writes down ultrasensitive.

When I get to the hospital, I insure that the lab person knows there is a difference. They have to check another screen to get it. I have gotten the wrong sensitivity laevl, have called the lab supervisor and gotten an ultrasensitive run for no charge.

As far as cost, I really don't care. Not my problem.
Goodlife
 
Age 58, PSA 4.47 Biopsy - 2/12 cores , Gleason 4 + 5 = 9
Da Vinci, Cleveland Clinic  4/14/09   Nerves spared, but carved up a little.
0/23 lymph nodes involved  pT3a NO MX
Catheter and 2 stints in ureters for 2 weeks .
Neg Margins, bladder neck negative
Living the Good Life, cancer free  6 week PSA  <.03
3 month PSA <.01 (different lab)
5 month PSA <.03 (undetectable)
6 Month PSA <.01
1 pad a day, no progress on ED.  Trimix injection
No pads, 1/1/10,  9 month PSA < .01
1 year psa (364 days) .01
15 month PSA <.01

Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25364
   Posted 12/13/2010 8:02 PM (GMT -6)   
Been getting PSA tests since 2002, clueless too on the cost, as I have never had to pay a cent out of pocket for any of them. Prior to dx, all were x.x tests, since dx, all have been .xx tests. I don't have to ask my dr., this is just his standard way.
Age: 58, 56 dx, PSA: 7/07 5.8, 10/08 16.3
3rd Biopsy: 9/08 7 of 7 Positive, 40-90%, Gleason 4+3
open RP: 11/08, on catheters for 101 days
Path Rpt: Gleason 3+4, pT2c, 42g, 20% cancer, 1 pos marg
Incont & ED: None
Post Surgery PSA: 2/09 .05,5/09 .1, 6/09 .11. 8/09 .16
Post SRT PSA: 1/10 .12, 4/8 .04, 8/6 .06 11/10 Not taking it
Latest: 6 Corr Surgeries to Bladder Neck, SP Catheter since 10/1/9, SRT 39 Sess/72 gy ended 11/09, 21 Catheters, Ileal Conduit Surgery 9/23/10

John T
Veteran Member


Date Joined Nov 2008
Total Posts : 4188
   Posted 12/13/2010 9:09 PM (GMT -6)   
I think that the post surgery guys should get the ultra sensitive psa and for those of us that that had radiation the regular psa is all that is needed. The last one at my local hospital cost $100. The VA did one psa test a year, but that was before I was Dxed. I don't think there would be any problem in getting more than 1 per year through the VA if you have PC.
JT
65 years old, rising psa for 10 years from 4 to 40; 12 biopsies and MRIS all negative. Oct 2009 DXed with G6 <5%. Color Doppler biopsy found 2.5 cm G4+3. Combidex clear. Seeds and IMRT, no side affects and psa .1 at 1.5 years.

Ziggy9
Veteran Member


Date Joined Jul 2008
Total Posts : 981
   Posted 12/14/2010 12:31 PM (GMT -6)   
erbob said...
Thought sure this thread would generate a LOT more interest since we are all subject to PSA tests.
Asked my Uro today, through his receptionist, which of the three PSA tests I should get at our local hospital. The receptionist relayed his response to me which was,
just tell the folks at the hospital that you want a PSA test. Sounds like he might not be too interested in my case. Guess I was just putting a little too much faith in his interest in me and my PC although he was the one who performed the biopsy and gave me the PC Dx....... mad


Some urologists take it personal when a patient opts for seeds over surgery. I also agree VA will give you a free Psa test. I just get some medications from them but they insist on at least an annual blood draw which includes PSA. If nothing else it confirmed my .32 PSA from 9 months earlier from my urologist.

If you're not a vet I believe most insurances will pay for it as long as your primary doctor requests it. I'd guess most would agree to do so if you asked.
Diagnosed 11/08/07 - Age: 58 - 3 of 12 @5%
Psa: 2.3 - 3+3=6 - Size: 34g -T-2-A

2/22/08 - 3D Mapping Saturation Biopsy - 1 of 45 @2% - Psa:2.1 - 3+3=6 - 28g after taking Avodart - Catheter for 1 day -Good Candidate for TFT(Targeted Focal Therapy) Cryosurgery(Ice Balls) - Clinical Research Study

4/22/08 - TFT performed at University of Colorado Medical Center - Catheter for 4 days - Slight soreness for 2 weeks but afterward life returns as normal

7/30/08 - Psa: .32
11/10/08 - Psa.62 -
April 2009 12 of 12 Negative Biopsy

2/16/10 12 of 12 Negative Biopsy

Post Edited (Ziggy9) : 12/14/2010 11:42:25 AM (GMT-7)


erbob
Regular Member


Date Joined Jan 2010
Total Posts : 281
   Posted 12/15/2010 4:56 PM (GMT -6)   
Contacted my Brachytherapy/Rad. Doc today who indicated that I should just get the Total PSA test. So, here we go.
Bob, located in Southern Colorado
Retired railroader
Born 1936
Dx Jan 2010, Volume 51.345
Gleason 3+4=7, second opinion 4+3=7 (Don't know which to believe)
Brachytherapy May 26, 2010
No catheters
First PSA three months after seeds 0.12
Doing just fine.
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