VIPDx XMRV test MOST LIKELY covered by Medicare.

Discussion in 'Fibromyalgia Main Forum' started by misskoji, Oct 29, 2009.

  1. misskoji

    misskoji Member

    I am including the insert I received with my 3 tests I received via Fed Ex today. In the literature (I have retyped and pasted below for everyone else to see) it says they will bill Medicare for you, and your supplemental insurance company.

    I got excited because I was worried about dishing over several hundred dollars for this test. On the other hand, I cannot wait any longer to have this test done.

    I called VIPDx to confirm that Medicare would pay for this test. Megan told me that they cannot gaurantee Medicare will cover this test, but it goes on a case-by-case basis. Medicare needs to find it medically neccesarry for you to have this test. My speculation is-well yes, this is very neccessary for those of us with immuno-deficiancies. It's just the red-tape process of it all really, it will take a while to be approved.

    I asked if I needed to send in payment with my tests and wait to be reimbursed by Medicare. She said NO, don't send in payment now, they will fight with Medicare for me. And in not so many words, she said something about the doctors wording in ordering the test. What the doctor says in order to get the test done affects how/if Medicare will pay for the test.

    As of now, I have no medical doctor, none. I decided after too much frustration to take a break from the medical community. I was seeing Dr. Lerner but the expense of travelling back and forth to him was too great. It was litterally a choice between seeing Dr. Lerner and keeping a roof over my head.

    I have decided I'm going to go back to Dr. Lerner for at least the testing and his input on treatment with the results.

    Here is the literature included with the tests:(Please forgive any spelling, format or grammatical errors as I just hurridly re-typed this and I'm exhausted already from watching the CFSAC today)

    Dear Clinicians and Patients:

    It is with great pleasure that Viral Immune

    Pathology Diagonsits (VIP Dx) announces the

    introduction of its family of diagnostic test for

    the Xenotropic Murine Leukemia Virus-like Virus for

    XMRV asscociated neurolgial disease (XAND).

    Test acceptance will commence on Octover 23rd, 2009.

    Please contact our Client Relations staff to arrange

    the shipment of test kits and acceptance of samples.

    Eac XANC acceptance coade is assigned by our staff

    and will arrive on the test requisition in your

    specimen kit. Specimens sent without the appropriate

    acceptance code may result in the delay or inability

    to perform the diagnostit test. The diagnostic tests

    available for XAND* are as follows:

    XAND by PCR for XMRV active infection :Test Code

    XAND ($400)

    XAND1 by virus culture for XMRV latent

    infection:Text Code XND! ($500)

    XAND2 by PCR for XMRV active infection and virus

    cuture for latent infection:Test Code XND2 ($650)

    Coming soon!
    XAND with Western Blot (reflexive) as confirmation

    of XMRV active infection

    AND by serology: Serological assay for XMRV IgG

    antibodies will be available shortly Samples

    requiring serological testing may be banked for

    future testing if requested.

    We are accepting XAND tests on Tuesdays and Fridays

    only due to the incubation period required for

    proper analysis. Therefore, you must have your blood

    drawn on Monday or Thursday and ship immediately

    back to us by priority overnight FedEX for receipt

    by us on Tuesday or Friday.

    For XAND testing you must use the coded test

    requisition provided with your kit. Refer to the

    updated specimen guidelines in the right column of

    the test requisition for proper blood draw.

    No special preperation is required for specimens;

    ship specimens at ambient (room) temperature.

    Specimens must be received within 24 hours for

    proper analysis. Collection and shipping

    instructions are included in each kit along with all

    required specimen tubes. The return clinical

    envelope and overnight airbill are also included.

    VIP Dx is a fee-for-service specialty clinical

    aboratory. Fees are due at the time of service. VIP

    Dx will continue to provide patients iwth a a

    complete statement with all ICD and CPT codes so

    that they can seek reimbursement from their own

    insurance company.

    VIP Dx will bill Medicare as lonog as the patient

    proovides a valid copy of their Medicare card and

    any supplemental insurance and the patient signs the

    ABN (Advanced Beneficiary Notice) located on the

    reverse side of the test requisition. Medicare

    patients wil be responsible for any fees not covered

    by Medicare and supplemental insurance.

    VIP Dx is committed to providing quality clincaly

    relevant tests, accurate, timely results and

    excelent customer service to aide the physician in

    the diagnosing and managing chronic vira and immune

    mediated diseases.

    We are very excited about our latest technology and

    new XAND test menu. To rder your test kit and check

    on test availability, please call Client Relations.

    Our client Relations desk is open from 9:00 a.m.

    5:00 p.m. Monday-Friday PST. Yu can also e-mail your

    request to

    You are invited to visit us at our website at

    On behalf of the VIP Dx team, we thank you for your

    continued support.

    Marguerite Ross, Director
    Marketing&CLient Relations
    VIP Dx

    *The XAND tests were developed and their performance

    characteristics were determinded and vaidated by VIP

    Dx. These tests have not been approved by the U.S.

    Food and Drug Administration (FDA) for diagnostic

    purposes. The XAND tests are for informational use

    and medical expertise is required for the correct

    [This Message was Edited on 10/29/2009]
  2. hensue

    hensue New Member

    Mine was shipped out on Wednesday they are in the west and I in the East so I am hoping i will get it soon.

  3. hensue

    hensue New Member

    You have three test? I am getting only two I think?
    What are they or am I not comprehending???
  4. misskoji

    misskoji Member


    I ordered three tests. One for me, one for my son, and one for my cousin who all live in my household.
  5. hensue

    hensue New Member

    Hoping to get it today or tomorrow so they can draw blood tomorrow.
  6. denis321

    denis321 New Member

    because this particular test is not approved yet by the FDA and not accepted widely in scientific/ medical circles, you might still be liable for the cost.

    The company may talk to your insurance company about covering it but if your insurance denies coverage and since you signed the ABN, this signifies that ultimately you are responsible for the cost.

    If you do get covered for it, let us know.
  7. panthere

    panthere Member

    Do they tell you how long until the results are ready?
  8. AuntTammie

    AuntTammie New Member

    one thing that I am a little concerned about (if Medicare does actually wind up covering this) is that we do not know yet if xmrv is causing CFS, but if it is not the cause (or if it is not the only cause) and someone with CFS gets tested and does not have xmrv, and if that person is on medicare bc of ssdi, then they could turn around and say that the person must not really have cfs and therefor will no longer be getting ssdi and/or medicare.....obviously there are a lot of what ifs in that thought, so it is not necessarily something to be extremely worried about, but it is something to consider before getting tested
  9. misskoji

    misskoji Member

    Everything you all have mentioned here.

    And thank you for bringing up hese important points.

    I am prepared to pay for this test if it comes down to that.

    Please don't quote me but I do beleive VIPDx is the lab the WPI is working with to develop the standard tests, or the contract for it, or something in that arena.

    I didn't ask how long the results will take, but I will find out and post when I find out in this thread.