Just wow... Damn!!

shana lewis
on 5/6/12 11:19 pm - TX
 So I'm getting pre-ops done for my TT on Friday, and this lady walks in, older but still
She tells me Cogratulations and I'm like for what?
She points to my belly and says " you must have just had your baby a day or so ago"
See, THIS is why I'm getting a TT Friday!!!
 
If you want a friend, show yourself friendly!!
        
martitalinda
on 5/6/12 11:28 pm
Congrats on your upcoming TT ... you are going to love it ... I had an insurance paid panniculectomy and getting rid of my huge skin flap/skirt and having it removed and totally tightened up was the best thing after my WLS that I ever did for myself... I LOVE LOVE LOVE my flat belly...  

Wishing you an uneventful surgery and a speedy recovery!!!!

View more of my photos at ObesityHelp.com

autumnsiggy2RNY 2/5/07 no regain having implemented lifestyle changes....

 

shana lewis
on 5/6/12 11:48 pm - TX
 Thanks!!
Insurance is covering mine as well
Im so excited- haven't had a flat tummy in over 15 years!!
How was your recovery??
 
If you want a friend, show yourself friendly!!
        
martitalinda
on 5/7/12 12:18 am
 It was awesome ... came back to work in 2 days and made covers for my drains ... heck I went to the OH Conference in Philly in 2008 with my drains in and 2 weeks post op from my panni ... I stuck my drains in my bra and had awesome looking tits for a day LOL....

My only drawback was that the drains were in for several weeks and after removal I developed hematomas and a seromas that were drained in the doctor's office ... no pain at all after surgery ... I was given #30 Vicodin and only took 3 the entire time ... I can't even see my scar ... Dr. Pan did mine and she is just awesome.... 

View more of my photos at ObesityHelp.com

autumnsiggy2RNY 2/5/07 no regain having implemented lifestyle changes....

 

datorres
on 5/7/12 3:12 am
 How do you get insurance to pay for a tt? we have bc/bs of Texas.
martitalinda
on 5/7/12 3:28 am, edited 5/7/12 3:29 am
On May 7, 2012 at 10:12 AM Pacific Time, datorres wrote:  How do you get insurance to pay for a tt? we have bc/bs of Texas. I have Anthem PPO ... check your policy re coverage for medical necessity ... you HAVE to meet certain criteria to qualify as medical necessity ... if it is cosmetic ONLY without meeting the criteria it is not covered.  ... You must meet criteria #1 and at least one other from the list provided .... I met #1 and three others .... my surgeon just grabbed my 'pochola' (name I gave to my skin skirt) and lifted it and took a picture and submitted it along with their office documentation/info from PCP and bariatric group ... My procedure was approved almost immediately after my plastic surgeon submitted my documentation....  it was less than a few days... not even a week.  

I copied this off this link  just in case it does not copy over ... check and see if your policy covers and if you meet this criteria:
 http://www.anthem.com/ca/medicalpolicies/policies/mp_pw_a053 328.htm 

Medical Policy




Subject:   Panniculectomy and Abdominoplasty
Policy #:   SURG.00048 Current Effective Date:   08/22/2011
Status: Revised Last Review Date:   08/18/2011

Description/Scope

This document addresses the surgical procedures panniculectomy and abdominoplasty and when they are considered medically necessary, not medically necessary and cosmetic.

Medically Necessary: In this document, procedures are considered medically necessary if there is a significant physical functional impairment AND the procedure can be reasonably expected to improve the physical functional impairment. 

Cosmetic: In this document, procedures are considered cosmetic when intended to change a physical appearance that would be considered within normal human anatomic variation. Cosmetic services are often described as those that are primarily intended to preserve or improve appearance. 

Position Statement

Medically Necessary:

Panniculectomy is considered medically necessary for the individual who meets the following criteria:

  1. The panniculus hangs below the level of the pubis (which is documented in photographs); AND
  2. One of the following:
    • there are documented recurrent or chronic rashes, infections, cellulitis, or non-healing ulcers, that do not respond to conventional treatment for a period of 3 months; OR
    • there is documented difficulty with ambulation and interference with the activities of daily living;
      AND
  3. Symptoms or functional impairment persists despite significant* weight loss which has been stable for at least 3 months or well-documented attempts at weight loss (medically supervised diet or bariatric surgery) have been unsuccessful;AND
  4. If the individual has had bariatric surgery, he/she is at least 18 months post operative or has documented stable weight for at least 3 months.

    *Significant weight loss varies based on the individual clinical cir****tances and may be documented when the individual:
    1. Reaches a body mass index (BMI) less than or equal to 30 kg/m2OR
    2. Has documented at least a 100 pound weight loss; OR
    3. Has achieved a weight loss which is 40% or greater of the excess body weight that was present prior to the individual's weight loss program or surgical intervention.

Panniculectomy is considered medically necessary as an adjunct to a medically necessary surgery when needed for exposure in extraordinary cir****tances. 

Not Medically Necessary: 

Panniculectomy is considered not medically necessary when the criteria above are not met.

Panniculectomy is considered not medically necessary as an adjunct to other medically necessary procedures, including, but not limited to, hysterectomy, or incisional or ventral hernia repair unless the criteria above are met.

Panniculectomy or abdominoplasty, with or without diastasis recti repair, for the treatment of back pain is considered not medically necessary. 

Cosmetic and Not Medically Necessary:

Liposuction is considered cosmetic and not medically necessary for all indications. 

Abdominoplasty when done to remove excess skin or fat with or without tightening of the underlying muscles is consideredcosmetic and not medically necessary.

Repair of diastasis recti is considered cosmetic and not medically necessary for all indications.

View more of my photos at ObesityHelp.com

autumnsiggy2RNY 2/5/07 no regain having implemented lifestyle changes....

 

shana lewis
on 5/7/12 4:26 am - TX
I have Aetna and my PS took pics of my tummy, lifiting it and everyhting- Sent it off along with documentation from my primary care physican about back pain, rashes underneath all that skin
I was approved in a few days for a complete abdominalplasty
 
If you want a friend, show yourself friendly!!
        
datorres
on 5/7/12 7:53 am
 Thanks for the info!I am definately going to try. I have been having terrible lower back pain recently and I'ts not due to that time of the month. 
goddessgrrl
on 5/7/12 2:46 pm - VA
That woman in the doctor's office has absolutely no home training. No one who was taught manners and courtesy ever asks any woman, "Oh, when's your baby due?" or "Did you just have a baby? I can tell by your tummy!"

Okay everybody, go home & tell your children not to ever ask a woman 1. her age or 2. when her baby is due.

That woman needs to be hit over the head with an etiquette book.

Best wishes with your TT shana!

View more of my photos at ObesityHelp.com

 

     

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