Recent Posts
Due to having developed hypoglycemia my surgeon wants to revise my bypass to a duodenal switch but in two separate surgeries. Will insurance approve this? Original surgery was in 2014.
Your journey sounds similar to mine. I was sleeved in May of 2012. Now I have osteo of the hip and desparately need a hip replacement. I've been to several doctors and most recently I was referred from one WLS surgeon to another to have the loop DS, aka SIPS/aka SADI. I am terrified. I want the Gastric Bypass but who can you trust?
Good Luck
Please read the following article so you can learn more about the DS, including that a SIPS/SADI/Loop surgery is NOT a DS. You should find a very skilled bariatric surgeon that is capable of performing the standard of care DS (2 anastomoses) and that has done many of them; therefore, you may need to travel for this surgery. The true DS has the best stats for resolution of co-morbidities, EWL%, and long term maintenance of weight loss.
What You Need to Know About Revising to Duodenal Switch (DS)
What type of revision did you have?
not technically a revision, my VSG was converted to the DS.
Your journey sounds similar to mine. I was sleeved in May of 2012. Now I have osteo of the hip and desparately need a hip replacement. I've been to several doctors and most recently I was referred from one WLS surgeon to another to have the loop DS, aka SIPS/aka SADI. I am terrified. I want the Gastric Bypass but who can you trust?
Good Luck
Smooches
Thank you again for your response. In a registered nurse with very little lifting at work I'm hoping to be off one week but I guess we will see. As it is in in a liquid/shake diet p look us one meal a day such as salad and a mixed either chicken or tuna salad with it...then ofcourse the other junk food my anxiety allows haha. I have lots of coworkers not wanting me to have the surgery but they've never been obese and had to deal with it for a life long time. I'm 48 years old and I know menopause will slow things down even more. Thank you for your support
I do not have Aetna I have Cigna. I was just going by what you wrote.
Conversion to a sleeve gastrectomy, RYGB or BPD/DS is considered medically necessary for members who have not had adequate success (defined as loss of more than 50 % of excess body weight) 2 years following the primary bariatric surgery procedure and the member has been compliant with a prescribed nutrition and exercise program following the procedure;
I don't understand what you mean by additional items. When it comes to a revision there are either complications or non-compliance.
I had a revision from band to bypass due to medical necessary. Even with an empty band it was tight and the acid reflux was horrible. I was eating tums like tic tac to get any relief. I tried to eat dense protein, but no matter how well I chewed or what type of meat it was I would vomit. When the revision was done it was found that the band was encased in scar tissue and that is what was causing my band to be tight. Had I not had the band out it would have eroded into my stomach.
So I will ask again what reason do you need a revision? What did the doctor find in your sleeve that you need to have a revision?
Dr. Sanchez Lapband 9/12/2003
hw305/revision w280/cw197/gw150
Revision from Lap Band to Bypass on 2/4/2015 by Dr. Pohl
Doctor went through the additional items with me and believes it to be medically necessary.
Do you have Aetna? Would love to understand your background to further understand yooy interpretation of the bulletin. Thanks!
From what I am reading it appears you have to wait the 2 years and it would have to be medically necessary in order to qualify for a revision. You would also of had to of been compliant with the prescribed nutrition and exercise program following the original procedure.
What is wrong with your sleeve? Why do you want a revision?
Dr. Sanchez Lapband 9/12/2003
hw305/revision w280/cw197/gw150
Revision from Lap Band to Bypass on 2/4/2015 by Dr. Pohl
Hi all,
I got the sleeve August 2017. I'm looking to get revision to either bypass or DS. Ideally, I'd like to knock it out quickly. Given I can get everything taken care of for pre-op diet, etc. I'm trying to understand if I could get it before the 2 year mark? The policy is a bit confusing:
Conversion to a sleeve gastrectomy, RYGB or BPD/DS is considered medically necessary for members who have not had adequate success (defined as loss of more than 50 % of excess body weight) 2 years following the primary bariatric surgery procedure and the member has been compliant with a prescribed nutrition and exercise program following the procedure;
Does this mean I need to wait till after the two year mark to submit to make sure I don't get debite for that reason? Has anyone submitted to Aetna POS II prior to the two year mark and been approved for coverage?
Any help would be much appreciated!
