Weight Loss Surgery Directory

By Location By Map


Photos

.
No Photos Have Been Uploaded Yet.
View Other People's Photos
I'm Not In Any Photos Yet.
Before & After

There are currently no before and after photos for this member.

See these instructions if you wish to submit your own Before & After photos.
Goals

No Public Goals Yet.
View The Goals Page
Surgeon Testimonial

Henry Buchwald M.D., Ph.D.
Loved Dr. B...hopefully I'll be approved by insurance and have this surgery.
Latest Surgery Support Comments

  • Comment by Frvsnt O. on 4/7/04 8:15 am
    Happy 4 Year Re-birthday to you!!! I found this quote and just love it! When running up a hill, it’s alright to give up as many times as you wish – as long as your feet keep moving. By - Shoma Morita M.D. I can only imagine that your pas few years have been wonderful. Full of changes and new experiences. I can hardly wait to see what I look like and feel like when I reach your spot!!! Congratulations to YOU!!! RNY 10/31/03 down 85 pounds!!!
  • Comment by Judi W. on 4/7/02 9:56 am
    Karla~~ Congratulations on your 2 yr. Anniversary!! You Look Fabulous! Hope your journey continues to bring you joy and good health. Hope you post on your profile...you are an inspiration to us.
  • Comment by Cinna G. on 4/7/02 6:07 am
    Happy TWO year anniversary to you. WOW, you were pretty in your pre-op picture. In your post-op picture you are even prettier. How are you doing? Please don’t forget to keep your profile updated so that others can travel along on this amazing journey. Have a wonderful anniversary day.
Click here for the surgery support page
Karla H.'s Blog
Karla H.'s Blog


May 2010
on May 26, 2010 4:19 pm

Had LapBand in Sept 2008 and lost about 20 pounds.

I'm now back up to 245....thinking about sending an application to the biggest loser.

Be the first to leave a comment.

02/26/08
on March 9, 2008 7:53 pm
I was denied by insurance saying that DS was an investigative procedure.

OK I found out more about my insurance.....below is from my Premera BCBS policy:
 
Coverage is provided for services and supplies for the surgical treatment of obesity. Benefits are available to you and your enrolled spouse/same-sex domestic partner (SSDP) when the following criteria are met:
  • Failed dietary and lifestyle change programs.
  • Body Mass Index (BMI) greater than 40 kilograms (kg) per square meter (m2) or BMI greater than 35 kg per m2 in conjunction with severe co-morbidities. Examples of co-morbidities include cardiopulmonary complications, severe diabetes, hypertension, or obstructive sleep apnea. 
  • To qualify for benefits, the procedure must be a gastric restrictive procedure listed as medically necessary in the Premera Medical Policy on Surgery for Morbid Obesity.
__,The key words in my policy is "gastric restrictive procedure" which includes:
 
1. Vertical Banded Gastroplasty – CPT Code 43842
2. Adjustable Gastric Banding – CPT Code 43770 (Laparoscopy, surgical, gastricrestrictive procedure; placement of adjustable gastric band)
3. Open Gastric Bypass – CPT Code 43846 (gastric restrictive procedure, with gastric bypass for morbid obesity, with short limb [150 cm or less] Roux-en-Ygastroenterostomy)
4. Laparoscopic Gastric Bypass – CPT Code 43644 (laparoscopy, surgical, gastric restrictive procedure; with gastric bypass and Roux-en-Y gastroenterostomy(roux limb 150 cm or less)
5. Mini-Gastric Bypass – No Specific CPT Code
6. Sleeve Gastrectomy – No Specific CPT Code
 
It does not cover any malabsorbtive procedures.

Another person on the OH DS Forum has the same insurance and when denied was told it was because it was investigative surgery....but it turned out that she was denied on all her appeals because our insurance does not cover the malabsorbtive procedures.....so I will try to appeal and keep my fingers crossed but it looks like if I want this procedure it will have to be self pay.
 
BUMMER......
Be the first to leave a comment.

02/12/08
on February 12, 2008 12:24 pm
Danette and Dr. Buchwald were on vacation last week so she has not called me back with information from my insurance company yet.  I called her yesterday and she is supposed to be calling me back.
Be the first to leave a comment.

02/02/08
on February 2, 2008 5:47 pm
Finally spoke to Dr. B.  He said it looks like I should have surgery.  I spoke with Danette and she is checking to see what my insurance needs.  I've already done testing and gotten letters from my PCP.  Plus supplied a notebook of information.  Hopefully it will go easily from here.
Be the first to leave a comment.

01/20/08
on January 20, 2008 9:10 pm
Haven't written in a while...finally got my upper GI and endoscopy.  I'm trying to get phone consult with Dr. Buchwald once he reviews my results.  Danette is getting my records and talking to Dr. B...then will call me back.
Be the first to leave a comment.

Browse pages: next >



Archive

Tags
  • None