RPL panel

[Anonymous]

Combing through records to file an appeal... What evaluations/tests/records do I need to show evidence of an RPL (recurrent pregnancy loss) panel? RPL evaluations in general??
Thank you!

[Anonymous]

This is a good list of tests on the panel:
https://www.questdiagnostics.com/testcenter/testguide.action?dc=TS_Recurrent_Miscarriage

But I'm confused have you already had it run and you are appealing because it wasn't covered? Or did your insurance not cover it saying you already had one? I'm not sure how my OB coded it I think it was "habitual aborter" but it was covered. We had multiple sets of betas and several incidents during various pregnancies where I came into her office with bleeding.

[Anonymous]

Wife has had 3 miscarriages. We went on my insurance effective jul 1 because IVF is covered. They denied the pre-authorization and we appealed and they denied the appeal as well ("not medically necessary"), so I am requesting an external/3rd party review with the state. I'm trying to meet all definitions, both policy and clinical. Our policy states that 3 spontaneous abortions is RPL, in which case IVF is permitted as long as there is "evidence of evaluation to determine the cause of the recurrent pregnancy loss." So, just trying to make sure I have all the supporting evidence from our records (which came at me piecemeal). Thus far I'm including:
-results of sonohysterogram
-karyotype reports
-genetic screening reports
-bloodwork (this one's a little tricky because wife and I had so much bloodwork done--what would be considered part of an RPL evaluation?)
Thank you all.