Severe ME Day of Understanding and Remembrance: Aug. 8, 2017
Determined to paper the Internet with articles about ME, Jody Smith brings some additional focus to Severe Myalgic Encephalomyelitis Day of Understanding and Remembrance on Aug. 8, 2017 ...
Discuss the article on the Forums.

Australian changes to B12 testing: Information

Discussion in 'Detox: Methylation; B12; Glutathione; Chelation' started by boo85, Jan 15, 2015.

  1. boo85

    boo85 Senior Member

    Messages:
    178
    Likes:
    41
    Just a heads-up about changes to B12 testing in Australia.

    Since November 1st 2014, you can only get the B12 test ONCE every 12 months. This is the standard test that doctors use measuring B12 in the blood. Apparently the government is cracking down on people getting multiple tests per year (ie, me) and will not pay for more than one test per year.

    I spoke to someone at Healthscope as well as someone from Medicare, and I am getting conflicting information about whether that means Medicare will only pay for the B12 test once per calendar year (1st Jan - 31st Dec), or whether the 12 months starts from the last time you had your B12 test. I was told, I think it was a girl from Medicare, that it's from when you last had the test done, but I'm not 100% sure. I don't want to get tested for it again and have to pay for a useless test when I already know I have B12 troubles. So I need to wait until July, which is when I last had the blood test.

    So I'm still confused as to whether the regular B12 test is for once per calendar year, or since it was last tested...

    I also couldn't get a straight answer from the lady I spoke to at Medicare about whether Medicare will pay for an Active B12 test if I've already used up my regular B12 test for that year. I know Medicare has stopped people from going overboard with the regular B12 test, but does that mean that Active B12 is included in that? So that if I've already gotten a regular B12 test within the last 12 months, will Medicare pay for the Active B12 test? Or is it included generally as B12 so they won't pay for it again? They are two different item numbers so I'm guessing they are different and that Medicare has only put a limit on the regular B12 test... But I don't know.

    Please let me know if you get a straight answer from anyone.

    In other news, Healthscope DOES test for intracellular B12 also known as holotranscobalamin. You can find it under "A" for "Active B12" on Page 13 of the Healthscope Pathology collection guide - http://www.healthscopepathology.com.au/index.php/download_file/view/326/97/

    If your doctor or healthscope nurse says that can't do that test, refer them to the guide because it is in there. The lady I spoke to on the phone said they didn't do it and she had never heard of it (and if she hadn't heard of it, it musn't exist, right? :rolleyes:) But when I got off the phone, after searching for it, I found it in the document...

    Active B12 is more accurate because while you may have B12 floating around in your blood, it doesn't necessarily represent that B12 is in your cells, where it is needed. The regular testing that doctors get (the one you now can only get once per year paid by Medicare) only tests B12 in the blood. But the Active B12 test, also known as Holotranscobalamin, is more accurate.

    I myself haven't asked for the holotranscobalamin test yet, and I think it could be reserved for people who have chronic issues with low B12. You might need to write this information down and explain it to your doctor who may not be aware that this test is available in Australia now.

    My doctors always bulk-bills and you need to make sure the "bulk bill" checkbox is checked so that it is billed to Medicare. I haven't yet rang up Medicare to see whether Holotranscobalamin is bulk-billable, but my guess is that if it is requested by a doctor that generally bulk-bills all of your tests, then Medicare should pay for it.

    Here's a PDF with the new Item Numbers for the two separate B12 tests - http://www.nps.org.au/__data/assets/pdf_file/0005/265325/Fact-sheet-vitamin-B12-tests.pdf

    In case you can't see the PDF, the item numbers are regular B12 test (66838) and Active B12 test (66839.)

    They are two completely different tests and have two item numbers. If your doctor simply writes "B12" on the pathology request form, you may need to handwrite that you want the "Active B12" test or "Holotranscobalamin."

    In my experience Healthscope, Medicare and doctors can all have varying information and knowledge about these tests, so you might get conflicting information like I did when calling around.

    Healthscope should also test B6, if you are curious about your B6 levels. It is on Page 152 of this document under "Vitamin B6" - http://www.healthscopepathology.com.au/index.php/download_file/view/326/97/

    B6 is hidden in MANY supplements and long-term use, as little as 20 mg per day over a few weeks can cause neuropathy in individuals, which can resemble low B12. You can read more stories here - http://www.medhelp.org/posts/Nutrition/B6-Toxicity/show/2642

    So if you have neuropathy, please get tested for high B6 too. You should also note that from what I've read of others' experiences, B6 can go down rapidly once you stop taking it, or stop taking the supplements that had it hiding inside, but the neuropathy after stopping B6 can take years to heal completely. The B6 is not in the blood anymore, but it is still in the muscles and cells. So even this test isn't perfect. But don't let a doctor say "Oh, well, your levels of B6 have gone down in your blood, so things should be fine now." No. That's not true at all. Neuropathy from high B6 toxicity does its damage long after the levels in the blood have gone down.

    I haven't gotten my results for B6 yet so fingers cross it got accepted into Healthscope ok, but when I got my blood taken to test B6, the healthscope lady who took my blood didn't even know whether they tested for B6, but she eventually found it on the Collection Guide I linked to and tested for it. So insist that they do test for it and get them to look at the collection guide if they say they don't test for it.
     
  2. alex3619

    alex3619 Senior Member

    Messages:
    12,488
    Likes:
    35,054
    Logan, Queensland, Australia
    I hope you can sort this out @boo86.
     
    boo85 likes this.
  3. taniaaust1

    taniaaust1 Senior Member

    Messages:
    11,901
    Likes:
    12,708
    Sth Australia
    I dont know the answer to that either re dates for sure thou I did get told that it went from when a test was last done (but I dont trust what is verbally said as its often given to me wrong) eg some are only allowed to be done every 3 months or every 6mths or whatever limit they have set. Do certainly check thou and get the answer in WRITING or you cant trust it.

    Our government also cut back on a heap of things about a year or so ago as I too was getting caught out with testing my doctors wanted to do. (

    Not only have they cut back for certain individual tests, they also have put limits on how "many different tests" one can have per doctors visit.. which can mean that someone then has to go to the doctors multiple tests just so they can get all the tests needed done.

    As far as Healthscope goes, you may find you will get completely different answers depending who you talk to there. I highly recommend trying to get confirmation on various things on tests in WRITING so at least then you can use the letter to show you were given wrong info when things go wrong.

    I got billed for a test I got told was covered ($30-40 I cant remember now exactly).. this happened AFTER I rang and was told it was covered. I ended up getting extremely upset and telling some head there I refused to pay the bill based on principle I was told the wrong thing by phone by them..and after several phone calls over it, they did let me off that bill "just this once" (if they make another mistake, I'll be charged next time).

    After this incident, in future I will be getting confirmation in writing from Healthscope on things and not going by info they give on phone.
    ..............

    What Ive found is that since the new rules were all introduced, even the doctors dont know what is too many tests and if they will be covered. This has happened to me at two diferent doctors over the past year or so.. they dont know when I ask and just say "I hope medicare will pay it for you, we'll have to just do it and see).

    They also introduced a newish thing on certain prescriptions too.. which means someone will loose the prescription repeats on some individual drugs, if you get the drug at the discounted prescription rate.. or one can pay more then that and get to keep the repeat prescriptons.

    The only way to get around this is to go to a doctor multiple times and get a new prescription each time and dont bother about repeats. If you are someone like me who cant leave the home without a support person, all these new rules (well not so new now, these have been in now for over a year I think).. this whole situation is a nightmare if you cant get to doctors multiple times.

    When they brought the new stuff in on limiting how many tests which can be done (it was probably 2 years ago now?).. they were targeting and closely checking up on those doctors who tend to often be our specialists as they do lots of tests (I had a couple of my doctors saying they were being closely watched over this). Anyway, you could end up with a bill unexpected test bill in which you thought you were covered for with no warning at all.
     
    Last edited: Jan 15, 2015
  4. boo85

    boo85 Senior Member

    Messages:
    178
    Likes:
    41
    @taniaaust1

    Hi Tania. Thanks for your reply.

    Yes, that sounds like Healthscope to give many different answers. One person says one thing, and another person says something totally different... I've even had conflicting reports from Healthscope and Medicare!

    I had no idea about doctors being watched closely to make sure they aren't giving to many tests. Isn't that the whole point? Do they think people enjoy going to the doctor, asking for tests, fasting overnight, getting blood taken, then going back for results? People do these tests because they are sick. And sometimes repeat tests over the year is kinda necessary to see how patients are progressing and on the right track. That's just absolutely terrible. Luckily I haven't seemed to have trouble with all the tests I've gotten over the past few years from my GP, but I will certainly keep an eye out. It shouldn't be a case of "wait and see" whether you get charged for pathology bills. Quite insensitive for a doctor to say that, seeing how much they get paid. But $30 - $40 can be a case between eating and not eating for the week, for some people...

    That's like when at my local clinic, which is a bulk-billing clinic, with bulk-billed tests, their printer or something didn't check the box that the tests needed to be bulk-billed. So I ended up getting a bill in the mail from Healthscope to pay for it. So I rang them up and explained what happened and they said the same thing to me as to you. That they'll let me off "Just this one time..." Uh, yeah, thanks, but I never should have been billed in the first place. It wasn't my mistake, it was the doctor's practice because their printer wasn't aligned properly. That's why it always pays to double-check that "bulk-billing" is checked on pathology forms.

    And yes, I totally agree that doctors aren't kept up to date about whether testing is put on a limit to the amount of times Medicare will pay. They should but a lot don't know. Similar to how my doctor didn't even know whether Healthscope does B6 testing. She said that she didn't think so, but I already knew and looked it up beforehand and knew that they did.

    One would think that when people present with neurological problems, one of the first things doctors should check is that B12 levels aren't too low, ideally with an Active B12 test. And that B6 levels aren't too high and whether patients have been taking vitamins with hidden B6 in it. But then again, doctors, even neurologists seem to think that all vitamins are water-soluble and that any excess is peed out. Nope - B12, even though is crucial for nerve healing, can produce potassium deficiency from rapid healing. And that B6 can cause nerve damage, which happened to me too.
     
  5. taniaaust1

    taniaaust1 Senior Member

    Messages:
    11,901
    Likes:
    12,708
    Sth Australia
    Sorry to hear you've already found all that out about Healthscope.

    Ive currently got bills from two different hospitals thou Im supposed to be bulk billed but obviously something has once again screwed up (On a disability pension I shouldnt be being sent bills for tests done while in emergency depts or in hospital etc). There is currently 3-4 bills to do with health stuff Im needing to sort out. Its hard as due to my brain issues I forget to check things like check if bulk billing is ticked etc
     
  6. Snow Leopard

    Snow Leopard Hibernating

    Messages:
    4,613
    Likes:
    12,435
    South Australia
  7. boo85

    boo85 Senior Member

    Messages:
    178
    Likes:
    41
    Thanks @Snow Leopard

    Do you know what constitutes as 'high risk' for B12, Vitamin D or Folate? Is there some criteria, or is it up to the doctor to decide whether the patient needs it?

    So if you are high risk, then you don't have to pay and Medicare will pay? But if you are low risk, then you must pay for it?
     
  8. Snow Leopard

    Snow Leopard Hibernating

    Messages:
    4,613
    Likes:
    12,435
    South Australia
    I really have no idea what the definition is to be honest, I think they are trying to force the patient/physician into justifying it.
     
    Valentijn likes this.

See more popular forum discussions.

Share This Page