In recent years, cancer policies have become more and more common. These allow for payment of benefits which can be used towards rent, groceries, medical bills and a host of other expenses when you are dealing with cancer and are unable to work.
Quite some years ago, a pathologist by the name of Ralph Richart developed the terminology commonly used today of intraepithelial neoplasia. "IN" can be preceeded with a C for cervical, V for vulvar, Va for vaginal and A for anal. This post deals with a diagnosis of CIN3 or cervical intraepithelial neoplasia grade 3.
Previously, there were four classifications of dysplasia/precancerous lesions grade 1 through 3 and the fourth being CIS or carcinoma in situ meaning cancer in it's place and not yet invasive. The difference between in situ and invasive is whether or not the abnormal cells have crossed the basal layer of the epithelium. CIN1, 2 and 3 indicate how much of the epithelial thickness the abnormal cells occupy. 1 = 1/3, 2 = 2/3 and 3 = 3/3 or all, down to but not passing beyond the basal layer.
There has been a lot of confusion lately regarding CIN3 and CIS with many people (including some healthcare professionals) claiming that these are two distinctly different entities. As a result, some people are having their cancer policy claims denied. Many policies will state that by their definition cancer includes CIS. However they will then go on to deny the claim if the patient has a diagnosis of CIN3. This is utterly absurd and nothing but sheer semantics. It is in fact, a combination of two sets of terminology, the old CIS and the new CIN3 and is about as useful as trying to compare apples and oranges.
There is in fact only one diagnosis code (ICD-9 code) for both of these 233.1 because they are synonymous. However, patients are losing out on their benefits because insurance companies certainly don't race to update the terminology in their policies or to pay out peoples claims. If they can deny a claim with this excuse all the better for them.
Patient's need to know to dispute this if their insurance company denies their claim for this reason. A letter from their physician should be sufficient.
http://arpa.allenpress.com/arpaonline/?request=get-document&doi=10.1043%2F0 003-9985(1999)123%3C0993:IITTRT%3E2.0.CO%3B2
http://www.faqs.org/abstracts/Health/A-modified-terminology-for-cervical-in traepithelial-neoplasia.html
Hopefully this will be helpful to any of you who have had this experience, or who run into this experience in the future.
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Michelle,
I wish I could say I was the "best in health" right now but unfortunately I'm dealing with an invasive HPV induced anal cancer.I've had surgery, and now am undergoing radiation twice a day and two rounds of chemo 4 days each.
As someone who advocates for HPV awareness (and have written a book due out Sept/Oct of this year) this situation came to my attention through another woman who had her claim denied for this reason. Thankfully, I was able to call Dr. Richart myself and clarify this since after all, he is the one who developed this nomenclature.
This particular woman was able to get her claim paid, but others need to be aware of this and so I felt it important to post it here as well.
August 2, 2009 - 8:12pmThis Comment
Thank you for sharing this information. I had no idea insurance companies were using this excuse to not pay claims for women who have cervical cancer. The links are very helpful as well.
I see you are a nurse. Did you learn this first hand from your own experience or that of a loved one or friend? Or, have you seen this where you practice as a nurse?
You will help a lot of women because you've stepped up and shared this information with us. Thank you so much!
Best in health,
August 2, 2009 - 1:52pmMichelle
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