Military Families

Does Tricare cover an NT scan?

I'm finding conflicting reviews online, and I thought I'd try here before calling them up.

My doctor never said it was optional, she just had the peri office call me and schedule something.

I have tricare standard.


TIA.

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Re: Does Tricare cover an NT scan?

  • If it is coded as medically necessary, I don't see why it wouldn't be.
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  • imageLissa832:
    If it is coded as medically necessary, I don't see why it wouldn't be.

    Thanks, that's what I was thinking to. I'm not at an age that would put me at higher risk for downs, etc.. Nor is there any family history of it. I think she just wants me to go get an NT since I've got twins.

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  • Tricare covered my NT scan, but I am AMA, so it was coded as medically necessary.

    FWIW, and it's been a little bit since I was pregnant, but I seem to recall that the NT scan was typically not as accurate for multiples. If you are seeing a peri, I would ask about that. Something about the blood levels being different and all.
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  • They covered mine.  I was worried they wouldn't, but I guess my doc coded it as necessary (had a m/c before DD1 & was a nervous wreck through first tri).
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  • Yes, it does cover it.  I had an NT with both pregnancies without an issue.  I am not AMA but I am high risk for other reasons (but nothing that would be helped by an NT).

    The NT is not as accurate with twins but they do adjust the blood value expectations for two babies.  I had an issue with my DD's pregnancy because I had a vanishing twin at 11 weeks and they were really concerned that with a deceased baby (I never expelled the baby - it was resorbed into my body over the course of my pregnancy) it would definitely throw things off...  So we chose to just do the u/s (to measure the nuchal and make sure a nasal bone was present) and not the bloodwork.

    With DS (a singleton) I had both the u/s and bloodwork without any issues.

     

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  • I had one a week ago and was told that it was.  I think as long as its coded in a way that shows its medically necessary, it would be covered.  In my case, I specifically requested it and they didn't even hesitate to set it up for me.  My age might've played into that though (mid 30s), not sure.  We have Prime.

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  • I just asked the same question in PGAL- we have reserve select right now. Anyone had it covered with RS?
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  • When I went in for my first appointment I had to sign a form acknowledging that Tricare may or may not pay for any ultrasounds and I would be responsible for payment if they didn't.  I also have Standard and they covered the NT Scan, the NT Scan re-do (they couldn't get a clear measurement the first time) and the anatomy scan.
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  • They covered mine--family history of neural tube defects. It was made clear that it was only covered because of that, though. Otherwise, OOP.
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