MaterniT21 vs NT

Rubygirl

Is it the norm to do both of these tests?  I'm scheduled for a second attempt NT scan tomorrow morning.  My first one - last week - baby would not cooperate and was laying flush to the uterine wall so they couldn't get a measurement.  I talked to my OB who recommended retrying the NT because in her words "it also checks for heart anomalies in conjunction with the measurements and blood results."  Which is odd to me because the U/S tech said the only thing she is getting is a neck measurement.  

So I asked about MaterniT21 (or similar tests), which the OB said they could either send me to an MFM to do or she was going to check with one of her office colleagues who might now do them.  

What I'm wondering is whether both are needed, especially given the potential inconclusiveness of an NT scan?  I'm 13 weeks today.  If my ticker is still showing up (I've tried updating to no avail, so I just tried to delete), it's off a few days.

siempreyo

I believe that NT is more the norm with the MaterniT21 being new and more optional.  The NT scan (in conjunction with bloodwork) will only give you a ratio/percentage possibility of your LO having one of the major three trisomny defects.  I believe during the scan they also look at other aspects of development, hence your OBs mention that it is good to do.  

 The MT21 looks at chromosomes so it can tell you definite (well with something like 99% accuracy) if your LO has downs, etc.   However, this is still considered "experimental", so I think this is in part why it is not the go to and still optional/additional in many places.

 If you definitely want to know vs having a probability I do think you can go directly to the MT21.

Not an expert, but based on my FTM experience (am at 20 weeks) so definitely not an expert.  Hope this helped. 

technigirl

I don't think that you really need to do both, although I did this time, mainly so I could get a look at the baby lol.  If I had to choose I would just do the MaterniT21 because it's more accurate.  They don't check vital organs like the heart at the NT scan because the baby is still too small.  That's what the anatomy scan (18-21 weeks) is for.  My NT technician and perinatologist also didn't look at anything besides the neck measurement and the overall length of the baby.

EMF70

My MFM doctor did the MaterniT21 after a failed attempt at an NT Scan.  He said that in our state, the test is only approved as a replacement for the NT Scan after the age of 35.  He also said that the MateniT21 test for my age group was more accurate than the NT Scan.  Why he didn't just give me the MaterniT21 test to begin with I don't know.  But it was nice to see the baby again on the attempted NT Scan.

danuli8

technigirl:

I don't think that you really need to do both, although I did this time, mainly so I could get a look at the baby lol.  If I had to choose I would just do the MaterniT21 because it's more accurate.  They don't check vital organs like the heart at the NT scan because the baby is still too small.  That's what the anatomy scan (18-21 weeks) is for.  My NT technician and perinatologist also didn't look at anything besides the neck measurement and the overall length of the baby.

I also did both, and admit that it was so I could see the baby (NT scan) AND get a good accurate result (MT21). I'm just greedy like that. The most important thing is to make sure your insurance will cover you having both.

danieleandwayne

I did the MaterniT21 instead of the NT. Like pp mentioned, the NT scan is the one measurement-- accurate assessment of heart defects don't begin to show up (and even then, it's not always visible until later) until the anatomy scan around 20 weeks.

The MaterniT21 test is new, but it uses your baby's DNA found in your blood. That's why it's so accurate. My OB said that after I asked about it, she did some research and she really believes that it will become the new Gold Standard for ruling out DS and the two other trisomies that it tests for.

It's interesting that EMF70's doc said the test is only "approved" as a replacement for the NT Scan after the age of 35. Approved by whom? Many insurance companies don't cover it yet because it's newer, but that's why the labs who run the test offer to waive the vast majority of the cost of the exam if your insurance doesn't cover it (they only charge you $235), because they want to be able to build the case that it's a more valid test than the NT Scan and quad screens (and cheaper in the long run). So with that deal, it's not like it matters whether or not your state approves of the test or does so under what criteria-- if you're willing to pay the $235, it's not like the test is illegal in those states. And if you're insurance is anything like mine, it wouldn't cover the NT Scan anyhow-- at least not 100%.

EMF70

I double checked with my husband since he was at the appointment with me.  My doctor was referring to NY State when he said that it's only approved for women over 35.  My husband added that the doctor said over 35 and other high risk groups.  My doctor said that it has nothing to do with the accuracy of the test for all types of pregnancies.  NY State is just conservative with the test and "approves" or "endorses" it for high risk pregnancies only. 

vintageutopia

My OB recommended both.

MT-Head

My OB (well, the MFM specialist the OB sends all 35+ patients to for intiial screening and anatomy scans) does the NT Scan as a matter of course, and offered CVS, Amnio and MaterniT21.  Despite the NT scan looking great, I also opted for the MT21 b/c it is so non-invasive and I wanted more assurance than the NT Scan.

Rubygirl

Well, I've already "seen" the baby twice via u/s - at 9 weeks and again last week at the failed NT scan.  I was supposed to go back today but the tech cancelled due to a familiar emergency.  The NT scan is approx $500-600, which will likely take the rest of my HRA dollars and most of my deductible.  I would rather get the MaterniT21 especially if it's half the cost, even if I have to pay the full amount.  I really want to get my OB on board with the MaterniT21 instead of NT, but I think because she doesn't do the M21, she's not as familiar with it.  In fact, her first statement was that she thought it only tested for one of the trisomies.  I countered her and she admitted she wasn't sure, but then talked about the NT looking at heart anomalies.  In any case, my time to get either test is running short.  

 

goatgirlnyc

danuli8:

I also did both, and admit that it was so I could see the baby (NT scan) AND get a good accurate result (MT21). I'm just greedy like that. The most important thing is to make sure your insurance will cover you having both.

 

This. I did both. 

Rubygirl

Called my OB's office and talked to her nurse.  They do offer MaterniT21 in office!  So glad I asked her about it last week because she had the nurse do more research.  So now I'm waiting on the CPT code so I can call insurance.  But I'm willing to not file it w/ insurance and just pay the $235. Thank you ladies SO much for the info! 

danuli8

Rubygirl:

Called my OB's office and talked to her nurse.  They do offer MaterniT21 in office!  So glad I asked her about it last week because she had the nurse do more research.  So now I'm waiting on the CPT code so I can call insurance.  But I'm willing to not file it w/ insurance and just pay the $235. Thank you ladies SO much for the info! 

Ruby, I just wanted to add that I had the MT21 test done while I was insured with United Health Care. They only covered a few hundred dollars of it, so I just got a bill yesterday from Sequenom (the lab that does the MT21) for $2200. I just called them and they said, "Of course we'll honor the $235 charge, just ignore that bill." I then gave them a credit card number, they charged my card $235, and bam, we're done. They said the insurance company requires them to send a bill with the "actual" amount on it so you can see how much the ins did or did not cover. But it took less than 5 minutes on the phone to clear up, and now I am square with them. Just wanted to reassure you that they kept their promise about the amount.

Rubygirl

Well unfortunately I'm not getting the same deal from Sequenom. I have United as well and Sequenom called them to verify my coverage. They are considered out of network and I have a 2500 deductible for our of network. So Sequenom gave me the option of not filing with insurance but I was told that rate is based on income. I knew I was screwed. I make too much even though DH is unemployed and a FT student. 590. The only option I was given was to pay in installments. No thanks. So I'll get the NT done and pray the results are normal. Watch it be too high and be sent to get the M21 anyway.

MeliGOP

I would say do both. I went straight to the MaterniT21 at 10w4d waited for two weeks for the result to find out I didn't have enouth fetal DNA in my blood and test could not be completed. So I did another one at 12w5d and guess what, two weeks later I found out the same thing happened again. I was now 14w6d and had already missed my window for the NT (sequential screening test). My only options are now to do the Quads test (which is an older, less accurate thest than the NT sequential test), redo the MaterniT21 or go straight to the amnio, which I want to avoid....

So, my advice - do both!!!

danuli8

Rubygirl:

Well unfortunately I'm not getting the same deal from Sequenom. I have United as well and Sequenom called them to verify my coverage. They are considered out of network and I have a 2500 deductible for our of network. So Sequenom gave me the option of not filing with insurance but I was told that rate is based on income. I knew I was screwed. I make too much even though DH is unemployed and a FT student. 590. The only option I was given was to pay in installments. No thanks. So I'll get the NT done and pray the results are normal. Watch it be too high and be sent to get the M21 anyway.

Ah, nerts, they want to charge you $590? Ouch. So sorry to hear that. I guess if worse comes to worst you could do the installments, but what a bummer they're not doing the 235 rate for everyone any more.

Margaret Lemon

I did just the mat 21 at 12 weeks. My doc told me that at 10 weeks the "not enough DNA" can be a problem. 

Call about coverage. I also have United and only paid $ 110 out of pocket. I think it varies so much by location and the specifics of your plan.