RNY - DS conversion

tiny1
on 12/18/14 11:19 pm - Clarksville, TN

Wanted to know the reasons you all are getting the conversion from RNY to DS? Does your insurance cover this? Is it medically necessary? I had RNY in 2004 and have gained back 40-50 lbs, but when I went to see my surgeon, he said my insurance would not cover the conversion. I went to Dr. Boyce and he does do the conversion. I have BC/BS Highmark and I know it will cover this surgery, if medically necessary. Just wanted to hear how to go about this. Any info is appreciated.

airbender
on 12/20/14 4:35 am

most people convert from rny to ds due to the poor quality of life with rny (mostly dumping, reactive hypoglycemia, they have gone rny revision and still have weight regain etc)  I think you answered your question, you said your insurance would cover it if it was medically necessary, you are aware that all insurance policies require it to be medically necessary (with the rare exception that you have a cosmetic rider on your policy).  most bcbs policies (this is verrrry broad) for revisions or conversions require that you qualify under the NIH guidelines even for revision and conversions, that information should be in  your policy.

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