I need advice. Doctors website says it does DS but there is no billing code?
I'm super frustrated because I had talked myself into getting a DS and I have an appointment to talk to my doctor on Wednesday to switch from Lapband procedure to the DS instead but now they are telling me that he doesn't like to do them because they have too many complications. I'm so bummed! WHY would they advertise it but then NOT do them? I can't even ask my insurance company if they will pay for it, does anyone know the code for it?
I did find out that if it is medically necessary they will do the sleeve but the doctor has to be willing to do it. Isn't the sleeve similar to the VGS or VBG or whatever its called?
Does anyone know of someone who got this and has success? I'm too scared to get the RNY :( I also know that if I get the lapband and a nurse *****s a hole in it and its rendered useless there is nothing my insurance will do about it. I could really use your help :)
I did find out that if it is medically necessary they will do the sleeve but the doctor has to be willing to do it. Isn't the sleeve similar to the VGS or VBG or whatever its called?
Does anyone know of someone who got this and has success? I'm too scared to get the RNY :( I also know that if I get the lapband and a nurse *****s a hole in it and its rendered useless there is nothing my insurance will do about it. I could really use your help :)
(deactivated member)
on 7/6/09 4:32 am - Woodbridge, VA
on 7/6/09 4:32 am - Woodbridge, VA
The sleeve is the VSG (vertical sleeve gastrectomy. This is the stomach part of the DS.
Find a new surgeon. Find a REAL DS surgeon. If someone has told you your surgeon doesn't "like" doing the DS, then run away. Run directly to the surgeons list on www.dsfacts.com.
Find a new surgeon. Find a REAL DS surgeon. If someone has told you your surgeon doesn't "like" doing the DS, then run away. Run directly to the surgeons list on www.dsfacts.com.
Yes, the VSG is much more effective than the Lap-band. There are no long-term studies yet, but I think the short-term studies are showing results closer to what you get from RNY. You also don't have to worry about getting fills, or the band slipping, or erosions.
If you really want the DS though, you need to expand your thinking. Most of us have to travel long distances for DS surgery because DS surgeons are few and far between.
First, decide for sure what surgery you want. Educate yourself about how each procedure works. Spend time on the boards for each surgery. Once you feel very certain about what surgery is right for you, then and only then should you chose a surgeon.
It's very common for surgeons to claim they do the DS just to get people in the door, then recommend a different surgery that they actually have experience with. We call that the "Bait and Don't Switch". Kick that guy to the curb.
If you really want the DS though, you need to expand your thinking. Most of us have to travel long distances for DS surgery because DS surgeons are few and far between.
First, decide for sure what surgery you want. Educate yourself about how each procedure works. Spend time on the boards for each surgery. Once you feel very certain about what surgery is right for you, then and only then should you chose a surgeon.
It's very common for surgeons to claim they do the DS just to get people in the door, then recommend a different surgery that they actually have experience with. We call that the "Bait and Don't Switch". Kick that guy to the curb.
I agree with Jules. Tell us where you are located and then there will be someone who can try to help you. There are surgeons out there that people know that may not be listed on dsfacts.com yet, but do do the DS surgery. You never know they may take your insurance. Do not give up yet and look at a different procedure...If you truly want the DS there may be ways.
Jennifer
Jennifer
(deactivated member)
on 7/6/09 7:39 am, edited 7/6/09 7:39 am - Woodbridge, VA
on 7/6/09 7:39 am, edited 7/6/09 7:39 am - Woodbridge, VA
You can fight it - apply for the DS, get denied, and appeal it. Also, didn't you mention Medicare? They cover the DS.
EDIT: just kidding, you said Medicaid, not Medicare. What state are you in?
EDIT: just kidding, you said Medicaid, not Medicare. What state are you in?
JL, I don't know where you are or who your potential surgeon is, or your bmi or comorbidities or really anything else, but I do know that lots of surgeons say, either on OH or their websites, that they do the DS when in reality they don't. We see this all the time. Anything to get you in the door. And once you're there, you will be told that there are more complications (not true, the complication rate is the same as for RNY), or that you will have diarrhea 10 times day (also not true) or that you will stink (also not true), or all of the above.
But if you have done your own research and read on this forum, you will know that none of this is true. The DS has the best statistics for excess weight loss, for maintaining that weight loss, and for resolution of comorbidities of any wls. And isn't it interesting that they DON'T tell you about the higher failure rate for RNY and lap band, the substantial number of people with significant weight regain, and that any comorbidities that went away will likely come back if you regain weight??
You need to start thinking outside the box. If that surgeon isn't right for you, find a different one, even if you need to travel further. If your insurance only covers lap band and rny, this is something you can appeal. Many, many people on this forum have appealed and won. It will depend on your insurance and your state. If none of that works and you are convinced that DS is the right choice for you, consider going to a foreign country - there are excellent DS surgeons in Mexico, Brazil, and Spain, and much cheaper than in the US.
Don't settle for the wrong operation. You will be living with this decision for the rest of your life.
Larra
But if you have done your own research and read on this forum, you will know that none of this is true. The DS has the best statistics for excess weight loss, for maintaining that weight loss, and for resolution of comorbidities of any wls. And isn't it interesting that they DON'T tell you about the higher failure rate for RNY and lap band, the substantial number of people with significant weight regain, and that any comorbidities that went away will likely come back if you regain weight??
You need to start thinking outside the box. If that surgeon isn't right for you, find a different one, even if you need to travel further. If your insurance only covers lap band and rny, this is something you can appeal. Many, many people on this forum have appealed and won. It will depend on your insurance and your state. If none of that works and you are convinced that DS is the right choice for you, consider going to a foreign country - there are excellent DS surgeons in Mexico, Brazil, and Spain, and much cheaper than in the US.
Don't settle for the wrong operation. You will be living with this decision for the rest of your life.
Larra
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