SIPS or SADI-Y

My surgeon did have to get prior authorization by doing a peer review with the medical director at bcbs. There is no code for SIPS just as there are no codes for lots of procedures. 

BCBSNC did indeed allow the SIPS FOR awhile but recently pulled their approval pending further studies.

I had heard that rumor also but someone else told me it was false.  However, I have a friend that had a consult last week.  She has BCBSNC and was offered the SIPS procedure.  I have not heard of anyone who has been denied SIPS from any insurer.  The surgeons at Bariatric Specialists of NC have done a bunch of SIPS procedures and are continuing to do them.  I think everyone gets an initial denial, as did I.  Because of the "newness" of the procedure, I believe BCBSNC requires medical review.  Its not a big deal.  Just another hoop to jump through.  My surgeon handled it and got the approval letter.  If anyone can confirm that BCBSNC no longer approves SIPS, please post.  By confirmation, I mean you or someone you know applied to have SIPS and was denied.  Otherwise, I believe this is still just a rumor.  

Agreed - my sips procedure was denied the first time, then approved. The insurance company paid 43k and I paid 2k.

Thanks so much for this post because I have seen this information on mybariatricpal.com, but again it was a hearsay post verses someone saying they were turned down and had to chose another procedure or surgeon because of the denial.

This is what I have heard so now I am wondering what people like me will do when our surgeon only does the SIPS version.  Especially since that was the revision I was told by my physician a couple of weeks ago would be his procedure of choice for me. 

I've already made an investment in this process with my time and money so I am positive things can be worked out, but it would be nice to know of other options that are successful revising a RNY.

Some other forums (other than OH) DO have sections for the SADI/LoopDS/SIPS. Do a google search of Single-anastomosis duodenoileal bypass and look on page two of the google results. First one listed after the studies.

Thanks

Hi! I had the SADI done on 12/3/13. I was 268 lbs and now im 110 lbs. It took me 14 months to loose 158 lbs. The surgery worked well for me and I love it ao far!