When  had my surgery I went to my prim care Dr. at the time and came clean, figured he's a Dr. so....  Then told him what my surgeon "Chettawut"  needed,  he ordered the tests,  had x-rays and blood work covered,  and I paid my co-pay. Now is not the time to be shy with a doctor, be frank with tell him what is up and be concise and to the point.  I was nervous as hell too when I went and told  him as I hadn't told him I was trans,  lol the look  on his face lol,  anyway he said my x-ray was to check for pneumonia, and the blood work was to test for my general health and auto immune disorders.  It went smoothly.