BCBS Federal Anyone?

TwinsMomma
on 4/5/17 12:54 pm

Hi! I am in the process of trying to get approval for a revision from lapband to sleeve. I have BCBS Federal. I have completed all my required appointments and now I am on the weight tracking for three months. My family dr recorded my weight for the past three months, which would have been sufficient but he did not use the diagnosis code for obesity so I had to start over in March. My packet has not been sent to the insurance yet, my Dr likes to make sure everything is up to par before submitting. Anyone successful with BCBS Fed approval for revision? I am most worried about the line saying that your first surgery wasn't successful. Mine was, I was at goal weight for a while.

Snowbutterfly
on 4/5/17 9:27 pm

I have bcbs federal. I put in for a revision from sleeve to DS and was approved in a day. I never reached goal and have documentation of mechanical faliure tho so my fast approval isn't normal. The surgeons office is usually really good at anticipating if u have everything in order so I'd just trust them. Good luck!

Gavin B.
on 4/6/17 5:35 pm - Orlando, FL

I will try the endoscopic suturing. I also have BCBS.

Gavin B.
on 4/6/17 5:40 pm - Orlando, FL

did you have an enlarged pouch? I do.

TwinsMomma
on 4/7/17 5:44 am

No, my pouch is normal.

Gavin B.
on 4/7/17 8:31 am - Orlando, FL

what justification you used?

TwinsMomma
on 4/7/17 9:10 am

My surgeon has not submitted to insurance yet. I have been seeing this surgeon for three years. My patient summary says "failure to lose weight with the lapband". "Weight gain due to excessive calories", "Patient has been compliant with exercise and food tracking" (I use a fitbit and my fitness pal to track. I print the report from there to bring to the office).

Snowbutterfly
on 4/11/17 5:32 pm

Yes my sleeve was enlarged. My gastroenterologist did an EGD for another reason and said it was so big he never would have guessed I had the VSG if he didn't already know. Later I had a barium swallow that confirmed it.

TwinsMomma
on 4/7/17 5:43 am

One day is awesome! My original surgery was approved in just a couple days and schedule for the very next week. I am hoping for such good luck now. I am in my three month tracking phase.

Gavin B.
on 4/7/17 5:28 pm - Orlando, FL

Why did you select DS over RNY?

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