Pre-op Lab Tests???
Hi Laura,
Here is what my surgeon's office does. I would see if you can get the Dexa Scan also for a baseline. I'm going to ask to get mine done now even though I am post-op. I can't imagine I had any damage done. There may be more items but I can't think of any right now. Notice the B6 needs to be foil wrapped. I don't think the lab wrapped mine so my value was sky high. Bring your own foil (learned that on the board).
You are getting so close. I can't remember if you said you need to do a liquid diet or bowel prep. Not sure which is worse :)
Here is what my surgeon's office does. I would see if you can get the Dexa Scan also for a baseline. I'm going to ask to get mine done now even though I am post-op. I can't imagine I had any damage done. There may be more items but I can't think of any right now. Notice the B6 needs to be foil wrapped. I don't think the lab wrapped mine so my value was sky high. Bring your own foil (learned that on the board).
You are getting so close. I can't remember if you said you need to do a liquid diet or bowel prep. Not sure which is worse :)
CBC
• • • • • • • • • • • • • • Note: VITAMIN A REQUIRES 2 ML FROZEN SERUM VITAMIN B6 REQUIRES PLASMA – FOIL WRAPPED
Hey Cathy - Thanks for the great list, and especially for the tip on taking my own foil! I hadn't seen that one anywhere before. I'm going to call my dr's office in a little while and see if they have a list of what they're having done, and if it doesn't match what *I* want, I'll see what I can do to get them ordered. My PCP would probaby order them for me if my surgeon balks, because his office isn't the easist to work with.
I don't have a bowel prep, which I thought was odd. All they're recommending is a 24 hour liquid diet the day before. But I'm going to try and go mostly liquid the week before, except for a few final favs here and there, just to get my liver down a little and take a few more pounds off that I've regained since I stopped my last pre-op diet for the NUT!
I'm off the next few days, and PROMISE I'll get on my desk top computer and post some human pictures on my profile!
Hope you're doing well!
I don't have a bowel prep, which I thought was odd. All they're recommending is a 24 hour liquid diet the day before. But I'm going to try and go mostly liquid the week before, except for a few final favs here and there, just to get my liver down a little and take a few more pounds off that I've regained since I stopped my last pre-op diet for the NUT!
I'm off the next few days, and PROMISE I'll get on my desk top computer and post some human pictures on my profile!
Hope you're doing well!
I don't have the list, but my pre-op labs were extensive enough that it took 4 labcorp workers to figure out how to do them. My insurance (Medicare) also didn't pay for most of them and I had a huge fight with labcorp about how they mark UP costs for people who have to pay it themselves. I got a slight discount and a two month payment plan out of it. I'm hoping that more of it will be paid post-op.
Becky
Becky
My list:
Not to be construed as medical advice, this list includes labs we have had performed as gastric bypass patients. The first group, every 3 to 6 months for life, as we are able. The second group, annually, as long as the results were comfortably within normal limits for more than 2 years in a row.
1st Group
*80053 Comprehensive Metabolic profile: (sodium, potassium, chloride, glucose,BUN, creatinine, calcium, total protein, albumin, total bilirubin, alkaline phosphatase, aspartate aminotransferase) (10231)
* 84134 Pre-albumin:
* 7600 Lipid profile: (cholesterol, HDL, LDL, triglycerides, chol/HDL ratio)
* 10256 Hep panel: includes ALT (SPGT) & GGT)
* 84100 Phosphorous - Inorganic: (718)
* 83735 Magnesium:
* 84550 Uric Acid: (905)
* 7444 Thyroid panel: (T3U, T4, FTI, TSH) (84437; 84443; 84479; 84480)
* 85025 Hemogram with platelets: (1759)
* 7573 Iron: TIBC, % sat
* 83550 Ferritin: (457)
* 84630 Zinc: (945)
* 84446 Vitamin A: (921)
* 82306 Vitamin D: (25-hydroxy) (680)
* 84052 Vitamin B-1: (Thiamin) (4052)
* 84207 Vitamin B-6: (Pyridoxine)
* 7065 Vitamin B-12 & Folate: (82607; 82746)
* 83970 Serum intact: PTH
* 83937 Osteocalcin:
* 84597 Vitamin K:
* 85610 PT:
* 85730 PTT:
2ND GROUP
* 593 LDH:
* 31789 Homocysteine, Cardio:
* 83921 MMA:
* 367 Cortisol:
* 84255 Selenium:
* 84590 Vitamin E:
* 82525 Copper:
For diabetics: *496 - HEMOGLOBIN A1C
POSSIBLE DIAGNOSIS CODES
269.2 Hypovitaminosis
268 Vitamin D deficiency
275.40 Calcium deficiency
266.2 Cyanocobalamin deficiency (B12)
281.1 other B12 deficiency anemia
281.0 Pernicious anemia
280.9 Iron-deficiency anemia
281.2 Folate deficiency anemia
285.9 Anemia, unspecified
269.3 Zinc deficiency
244.9 Hypothryoidism
250.0 Diabetes
401.9 Hypertension
276.9 Electrolyte and fluid disorders
272.0 Hypercholesterolemia
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
*579.3 Surgical malabsorption*
*579.8 Intestinal malabsorption *
* Bands or sleeves should not use these codes as they are not accurate.
*Some insurance companies will not pay for any procedure that uses these codes.
LAB TARGETS
This is NOT medical advice, just my own targets for the main blood levels I watch.
Protein: 7's
Albumin: 4's
Pre-Albumin: 20-30's
Iron: 80-100
Ferritin: 200-300
HGB: 12+
HCT: 36+
Vit A: 60- 80
Vit D: 80-120
Calcium: 9.0-9.4
PTH: 20-40
Vit B1: Mid to top of range
Vit B6: Mid to top of range
Magnesium: Mid range (but also go by if we have leg/foot cramping)
Zinc: Mid range
Vit B12: 1000 +
Folate: Top of range
AST (sgot): Below 40
ALT (sgpt): Below 40
We usually want to "meet or beat" pre-op levels. In some cases, higher is better, and in other cases (Cholesterol, PTH for example), lower is better.
The only things *I* don't mind being on the high end of out of range are Ferritin and B12. But that applies to ME.
My doctors don't show interest in any of these until I am out of range. *I* am interested when I begin heading that direction.
Not to be construed as medical advice, this list includes labs we have had performed as gastric bypass patients. The first group, every 3 to 6 months for life, as we are able. The second group, annually, as long as the results were comfortably within normal limits for more than 2 years in a row.
1st Group
*80053 Comprehensive Metabolic profile: (sodium, potassium, chloride, glucose,BUN, creatinine, calcium, total protein, albumin, total bilirubin, alkaline phosphatase, aspartate aminotransferase) (10231)
* 84134 Pre-albumin:
* 7600 Lipid profile: (cholesterol, HDL, LDL, triglycerides, chol/HDL ratio)
* 10256 Hep panel: includes ALT (SPGT) & GGT)
* 84100 Phosphorous - Inorganic: (718)
* 83735 Magnesium:
* 84550 Uric Acid: (905)
* 7444 Thyroid panel: (T3U, T4, FTI, TSH) (84437; 84443; 84479; 84480)
* 85025 Hemogram with platelets: (1759)
* 7573 Iron: TIBC, % sat
* 83550 Ferritin: (457)
* 84630 Zinc: (945)
* 84446 Vitamin A: (921)
* 82306 Vitamin D: (25-hydroxy) (680)
* 84052 Vitamin B-1: (Thiamin) (4052)
* 84207 Vitamin B-6: (Pyridoxine)
* 7065 Vitamin B-12 & Folate: (82607; 82746)
* 83970 Serum intact: PTH
* 83937 Osteocalcin:
* 84597 Vitamin K:
* 85610 PT:
* 85730 PTT:
2ND GROUP
* 593 LDH:
* 31789 Homocysteine, Cardio:
* 83921 MMA:
* 367 Cortisol:
* 84255 Selenium:
* 84590 Vitamin E:
* 82525 Copper:
For diabetics: *496 - HEMOGLOBIN A1C
POSSIBLE DIAGNOSIS CODES
269.2 Hypovitaminosis
268 Vitamin D deficiency
275.40 Calcium deficiency
266.2 Cyanocobalamin deficiency (B12)
281.1 other B12 deficiency anemia
281.0 Pernicious anemia
280.9 Iron-deficiency anemia
281.2 Folate deficiency anemia
285.9 Anemia, unspecified
269.3 Zinc deficiency
244.9 Hypothryoidism
250.0 Diabetes
401.9 Hypertension
276.9 Electrolyte and fluid disorders
272.0 Hypercholesterolemia
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
*579.3 Surgical malabsorption*
*579.8 Intestinal malabsorption *
* Bands or sleeves should not use these codes as they are not accurate.
*Some insurance companies will not pay for any procedure that uses these codes.
LAB TARGETS
This is NOT medical advice, just my own targets for the main blood levels I watch.
Protein: 7's
Albumin: 4's
Pre-Albumin: 20-30's
Iron: 80-100
Ferritin: 200-300
HGB: 12+
HCT: 36+
Vit A: 60- 80
Vit D: 80-120
Calcium: 9.0-9.4
PTH: 20-40
Vit B1: Mid to top of range
Vit B6: Mid to top of range
Magnesium: Mid range (but also go by if we have leg/foot cramping)
Zinc: Mid range
Vit B12: 1000 +
Folate: Top of range
AST (sgot): Below 40
ALT (sgpt): Below 40
We usually want to "meet or beat" pre-op levels. In some cases, higher is better, and in other cases (Cholesterol, PTH for example), lower is better.
The only things *I* don't mind being on the high end of out of range are Ferritin and B12. But that applies to ME.
My doctors don't show interest in any of these until I am out of range. *I* am interested when I begin heading that direction.
Michelle
RNY, distal, 10/5/94
P.S. My year + long absence has NOTHING to do with my WLS, or my type of WLS. See my profile.
I just may need those!
You're such a sweetie! Thanks! What color? Actually, Don is the one who put the roses in. I'm not that smart. LOL
But it delights me to hear that a rose has made someone's day brighter or collect what ppl have done with their roses over time. Very heart warming stories
But it delights me to hear that a rose has made someone's day brighter or collect what ppl have done with their roses over time. Very heart warming stories
Michelle
RNY, distal, 10/5/94
P.S. My year + long absence has NOTHING to do with my WLS, or my type of WLS. See my profile.
Hi Laura
I found out the hard way that you want them to do all of them just under whatever code the surgeons office "normally" bills the bloodtests under.
My PCP used all the codes on the list I got from Vitalady and boy what a mistake that was.
The lady at labcor did a great job, it took her for ever to get all the vails together and she made sure again and again that it all was the way it should be, but naturally my insurance that has always paid for all my bloodwork would not pay because of the way it was coded. (I was selfpay for the surgery)
And so labcor sent me a bill.
I thought I was going to have a heart attack on the spot, $2,800.-.
OMG
Thank goodness my PCP sent the right code to labcor and they resubmitted.
If your insurance is paying for the surgery there should not be a problem with them paying for the labs.
I also read you need to fast and not take any vitamins for at least 14 hours before the labs are drawn.
Good Luck
Inge
I found out the hard way that you want them to do all of them just under whatever code the surgeons office "normally" bills the bloodtests under.
My PCP used all the codes on the list I got from Vitalady and boy what a mistake that was.
The lady at labcor did a great job, it took her for ever to get all the vails together and she made sure again and again that it all was the way it should be, but naturally my insurance that has always paid for all my bloodwork would not pay because of the way it was coded. (I was selfpay for the surgery)
And so labcor sent me a bill.
I thought I was going to have a heart attack on the spot, $2,800.-.
OMG
Thank goodness my PCP sent the right code to labcor and they resubmitted.
If your insurance is paying for the surgery there should not be a problem with them paying for the labs.
I also read you need to fast and not take any vitamins for at least 14 hours before the labs are drawn.
Good Luck
Inge
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