What is the 11/12 week ultrasound?

[Deleted]

I'm going in for blood work today to be sent in for Counsyl, our niece was born with CF. I wasn't sure though about the ultrasound they mentioned in passing that can be done at 11/12 weeks. What is that one for? I had a folic acid deficiency prior to getting pregnant, my numbers seem in check now though, is Spina Bifida one of the things that would be seen on that ultrasound?

Not sure whether I should call and let them know to schedule the ultrasound for my next appointment or not. Is that one that is not usually covered by insurance?

[doodler]

Is that when they do the Nuchal Scan? I think mine was around 12 weeks last time.

eta: if it is the nuchal scan I have never heard of it not being covered by insurance.  I would call if you are unsure though.

[Deleted]

doodler, calling insurance was so confusing for the Counsyl panel! I think I'll request the ultrasound and hope it's covered. Maybe I can push my next appointment a week, technically it's on 10w6d so that is probably too early.

I have to pay $5 for parking each time I go too so I don't want to have to keep going back.

ETA - the tag for you doodler is strange so hopefully I'm not tagging someone random.

ETA again... I'm off a week. I'll be 9w6d at the next appointment so it doesn't matter then anyways.

[doodler]

You got the tag right

You might be able to call your office and ask. I know mine has you sign a form up front with the estimated charges for all of the prenatal care. For something common like a nuchal scan they might know.

Also, I am with you in not wanting to call insurance. Last time I spent hours on the phone trying to figure out how to order my free breast pump. I finally had it all figured out and the day I had him I called and ordered the damn thing from the hospital because I couldn't order until he was born. About a week later I got a call that they couldn't mail it because they were no longer a preferred provider for my insurance company. Cue ugly hormonal crying and another several hours on the phone with insurance to figure it all out.

[Deleted]

doodler, sigh. Surprisingly the guy at insurance was easy but then Counsyl/my doctor confused me. So now I have to do the blood draw and then wait to see if insurance will cover it and if not we'll have like a day to decide if we want to fork over the $400 for the test. I'm just really hoping the guy was right and that insurance will be covering the test.

[minae01]

The 11/12 week ultrasound would be the NT scan that checks the nuchal fold on the baby's neck. In conjunction with the bloodwork, they are able to screen for genetic abnormalities. You have to be between 11-13 weeks (I think you can be almost 14 weeks now) for the ultrasound. 10w6d may be too early. It is optional, but strongly suggested if there is a history of genetic problems in the family. Some insurance companies cover it. Maybe in your case, since your niece has CF, they would cover it. I have had it with both my kids and will have it with this one even though there is not history in my family. My insurance covers it.

I don't think they can tell about Spina Bifida yet - that's a blood test (AFP) around 16 weeks.

[Deleted]

minae01, thanks! When I'm there today I'll ask about pushing my appointment 1-2 weeks so maybe they can do the appointment/ultrasound in one trip. Last time I wanted the appointments early and as many as I could get and now with DD I just want it to be as easy as possible!

[doodler]

I hope you can get it all figured out! I am shuddering just thinking about all the insurance crap. Last time I was on DH's insurance but it would have ended up costing between $6000-$7000 so I switched to mine during open enrollment. Well somehow(despite me filling out early admissions paperwork and giving them my card when I went into labor) the hospital got DH's insurance information instead of mine and submitted EVERYTHING to the wrong company. Of course it all got denied and it was such a cluster to deal with. The anesthesia company took like 6 months to finally listen to me and submit it to the right company. I had collections calling me and threatening me. It was a nightmare!!!

Sorry I have totally hijacked your post to complain about insurance crap, lol. It feels good to vent though ;P

[steveo]

@aest, my guess is the insurance stuff they may have confused you about is that for some insurance, they will cover only one of cfDNA (like Counsyl) or the NT scan, since they essentially do the same thing (tell you probabilities of issues and whether you should pursue further testing). If you are getting Counsyl, your insurance may take the position than the NT is not medically necessary.

Spina bifida is normally tested for in the second tri AFP screen, and if there are markers you would be offered an amnio. Only an amnio can give a definitive prenatal diagnosis of neural tube defects.

[Deleted]

doodler, so stressful! We switched insurance since having DD, I owed $150 for the hospital then but this time it looks like it'll be completely free.

steveo, good to know, I'll hold off then and just do Counsyl first. No one on my side has had any sort of genetic issues but since I know at least DH's brother is a carrier for CF I figured I'd do testing this time. Last time we just skipped all of this so I have no idea what I'm doing. AFP is more blood work?

[JoeLies]

@ismellbooks - I think maternity21 is generally suggested for AMA, vs. amnio or other similar tests that carry some level of risk. While the NY scan gives you a probability (i.e., 1 in 2,000 chance of Downs, etc.), the blood test will give you an absolute Y/N. That's my understanding anyhow, though they're supposed to talk to me about it at the NT scan; apparently my office doesn't schedule that. Odd.

[steveo]

Aug 28, 2015 14:38:18 GMT -5 JoeLies said:

@ismellbooks - I think maternity21 is generally suggested for AMA, vs. amnio or other similar tests that carry some level of risk. While the NY scan gives you a probability (i.e., 1 in 2,000 chance of Downs, etc.), the blood test will give you an absolute Y/N. That's my understanding anyhow, though they're supposed to talk to me about it at the NT scan; apparently my office doesn't schedule that. Odd.

Cell Free DNA tests (maternity21, counsyl etc.) do NOT give a definitive Y/N. They also only give probabilities, just like the NT scan -- I'm not certain, but I do believe they do have a wider range of conditions for which they can produce probabilities than the NT scan (i.e. some chromosomal microdeletions etc.)

If you were to get a high probability back on a cfDNA test, you would discuss whether to pursue invasive testing (CVS / amnio) with a genetic counselor at that stage. Only the invasive test can be used for actual diagnosis (i.e. an absolute Y/N).

[ciaobaby]

With DS, I had the NT scan ultrasound with blood work at 12 weeks. My doctor gave me the billing code so I was able to call my insurance in advance to ensure what would be covered. I actually had to go to the hospital for it; my OB does ultrasounds in office but apparently not the NT scan. The results of the ultrasound and blood work were combined to give me a probability of having a child with a genetic issue (ex. was told I had a 1 in 10,000 chance). I plan to do it again with this baby, while also remembering that the results are not a definitive diagnosis. One of my girlfriends went in and was told that the nuchal fold in the neck was thicker than normal, which scared her and stressed her out. She then did a cfDNA test which ruled out trisomies and a later ultrasound showed the baby developing as it should.

[Deleted]

ciaobaby, my OB is at the hospital but they send patients across the hospital to the MFM group for the NT scan. I guess I'll just see about the Counsyl test first.

JoeLies, I am under the impression that it only gives probabilities also and that it does not give a Y/N answer. Unfortunately my SIL tested negative for CF during her testing so they never even tested my BIL but now we know CF at least runs on DH's side of the family.