A question
Hi Annie,
I agree with Suzanne. I think that we all go into the process with an idea of the surgery we want. I imagine that your friend should go to the seminar that Duke holds. She can ask them if there is an upper weight limit threshold for LapBand there. She doesn't have to share her weight or get them to give her a specific answer related to her own case, but could get general information. If her insurance allows her the latitude to consider other programs locally, I would also urge her to attend informational meetings at UNC Chapel Hill and possibly the program at Rex in Raleigh. As you know, my insurance dicated a Medicare Recognized Center of Excellence and Duke is the only one in the Triangle area. That said, you also know that I checked out the other programs in the area. This allowed me to gather a lot of information and enter the process more informed.
I wish Ruth every success as she ventures on the journey of a lifetime.
Barb
Barbara
ObesityHelp Coach and Support Group Leader
http://www.obesityhelp.com/group/bcumbo_group/
High-264, Current-148, Goal-145
First visit to surgeon - 288 ~ bmi 45.1
2 week pre-op 252 ~ bmi 39.5
Total lost - 153 Since surgery - 117!
Goal weight - 155 (mine) 180 (surgeons)
Current weight - 135 (2020 I lost 10lbs due to dedicating myself to working out more and being in better shape)
1/14/2025 still maintaining 135 :-)
Extended TT, lipo, fat injections - 11/2011
BA/BL/Arm Lift - 7/2014
Scar revision on arms - 3/2015
HALO laser on arms/neck 9/2016
Thigh Lift 10/2020
Thigh Lift revision 10/2021
First visit to surgeon - 288 ~ bmi 45.1
2 week pre-op 252 ~ bmi 39.5
Total lost - 153 Since surgery - 117!
Goal weight - 155 (mine) 180 (surgeons)
Current weight - 135 (2020 I lost 10lbs due to dedicating myself to working out more and being in better shape)
1/14/2025 still maintaining 135 :-)
Extended TT, lipo, fat injections - 11/2011
BA/BL/Arm Lift - 7/2014
Scar revision on arms - 3/2015
HALO laser on arms/neck 9/2016
Thigh Lift 10/2020
Thigh Lift revision 10/2021
on 5/6/08 5:25 am - NC
Indications and Limitations of Coverage
B. Nationally Covered Indications
Open and laparoscopic Roux-en-Y gastric bypass (RYGBP), open and laparoscopic Biliopancreatic Diversion with Duodenal Switch (BPD/DS), and laparoscopic adjustable gastric banding (LAGB) are covered for Medicare beneficiaries who have a body-mass index >35, have at least one co-morbidity related to obesity, and have been previously unsuccessful with medical treatment for obesity. These procedures are only covered when performed at facilities that are: (1) certified by the American College of Surgeons as a Level 1 Bariatric Surgery Center (program standards and requirements in effect on February 15, 2006); or (2) certified by the American Society for Bariatric Surgery as a Bariatric Surgery Center of Excellence (program standards and requirements in effect on February 15, 2006).
A list of approved facilities and their approval dates are listed and maintained on the CMS Coverage Web site at http://www.cms.hhs.gov/center/coverage.asp , and published in the Federal Register.
C. Nationally Non-covered Indications
The following bariatric surgery procedures are non-covered for all Medicare beneficiaries:
- Open adjustable gastric banding
- Open and laparoscopic sleeve gastrectomy; and
- Open and laparoscopic vertical banded gastroplasty.
The two previously non-coverage determinations remain unchanged - Gastric Balloon (Section 100.11) and Intestinal Bypass (Section 100.8).
