Traditionally, the method used to test for tuberculosis has involved inserting a needle under the skin and injecting a special protein. The injected substance forms a small bubble under the skin, and the patient will need to be monitored over the course of 48 hours to check the consistency and hardness of the bubble. If the bubble becomes hard and rigid, tuberculosis may be suspected. If the bubble disappears and is absorbed into the body, then the patient is not suspected of having been infected with tuberculosis. Only a qualified medical professional should read and interpret the results of such a test. It’s important to follow all directions provided when following up with your doctor if you have a tuberculosis skin test performed.
Today, however, newer tuberculosis tests are available that provide more accuracy by testing a patient’s blood. The problem with a skin test is that it does not provide direct numbers that can be used to demonstrate the presence of tuberculosis. Today’s blood tests, including QuantiFERON gold tests, offer more reliability and reduce the chance for false positives and the prescribing of unnecessary or potentially harmful medications.
What is a QuantiFERON Gold Test?
QuantiFERON gold tests are blood tests that require whole blood, meaning they rely on a typical blood sample instead of just plasma or other isolated components of the blood. These tests are carried out in a doctor’s office, clinic or hospital setting, and once acquired, the blood sample is analyzed in a lab. The sample is time-sensitive, so the sample must be analyzed within 14 hours in order to maintain accuracy.
When blood is drawn, it is stored in specialized laboratory tubes that contain a unique inner coating. Blood that is infected with tuberculosis will cause a reaction when it touches the coating, providing lab professionals with confirmation that tuberculosis is suspected. This type of testing may be used independently of skin testing, but in many cases, both will be used together to further confirm he presence of tuberculosis.
Does Medicare Cover QuantiFERON Gold Tests?
Medicare does routinely cover blood testing under Part B, which is the outpatient benefit for medically necessary services. As such, QuantiFERON gold testing is usually covered by Medicare. A deductible will likely still apply, and a co-pay may be due at the time of the blood draw. Additionally, the testing will need to be carried out at a lab that has been approved by Medicare in order to receive coverage. You may be able to seek out an independent lab on your own to have your blood tested using a QuantiFERON gold test, but if the facility is not a Medicare-approved provider, you will likely have to pay the full amount out-of-pocket.
Aside from Part B, coverage may be provided under Medicare Part A if a QuantiFERON gold test is administered during a hospital admission. This part of your Medicare benefits would also apply if testing is completed while residing in a skilled nursing facility. Coverage limits may change, however, depending on your plan, so if possible, speak with your plan manager prior to admittance to understand the specifics of your coverage if you know that a quantiFERON gold test will be performed.
Does Medicare Advantage Cover QuantiFERON Gold Tests?
Medicare Advantage recipients who need to have a QuantiFERON gold test performed will receive the same coverage as those covered by Original Medicare benefits, but those enrolled in a Medicare Advantage plan may have access to additional benefits. If you have any questions about the QuantiFERON gold test, talk to your doctor to discuss your concerns.