self pay for DS or insurance pay for RNY

My insurance will most likely pay for a revision to RNY but what I really want is the DS which my insurance will not pay for.  I see alot of revisions from RNY to DS.  My revision will be from stomach stapling in 1991.  So do I bite the bullet and self pay for the DS or go with the RNY which my ins. will pay.  Thanks for any and all input.  

Someone correct me if I'm wrong, but I believe you just need insurance approval for a "revision," not for RNY or DS specifically. I believe the CPT code for a revision is different from those for individual procedures.

I'm with BCBS of Ma. and they state in their medical policy that RNY is covered along with lap band but  several surgeries are not,  one of them being the DS   My insurance doesn't consider revisions.  Every surgery is as if it is new.

Just depends on your finances. I am very thankful that my ins. did cover the DS, but I would not have self-payed to get it. I would have had the RNY if the DS had not been available to me through insurance. Just wouldn't have wanted to stick my neck out for that kind of money as it would have used all our savings plus some.
-Wanda

You need to talk to a DS surgeon and let them battle your insurance.  Now a days, they will win.  It is all in the coding and billing.  Definitely, if you are already looking at a revision, go for the one with the highest chance of long term success.  You DON'T want to be looking at another revision 4 years from now.  JMHO!   Best of luck.

Hijack!  Where'd your pic go, young lady.  It's not cool to go all incognito after I've spent 3 years looking at your smiling face.

I've actually got a new one coming that is smiling!!!   I look kinda "crabby" in the other avitar and we both know us skinny DS girls are smilin' kinda girls LOL!  Just gotta get my photoshop skills up to par . . .

That completely depends upon you, and the post-op lifestyle you can live with.

The RNY and DS have radically different lifestyles, in my opinion. I chose the DS because I wanted to be able to take NSAIDs for pain if needed (can;t with RNY), was afraid of possibly dumping on every little thing I ate, and I wanted long-term SUCCESS. The stats are out there (check www.dsfacts.com). Most people lose more weight with the DS than the RNY and...KEEP IT OFF. 

Some people are very successful with their RNYs and love that they dump, as they feel it keeps them honest. I have two small kids who need me to be conscious and alert for them, 24 hours a day. I can't crawl off to bed for a few hours until sudden dumping from a piece of fruit or cookie subsides. (Keep in mind that not all people with RNY dump and those who do cannot necessarily predict what will make them dump.)

We have a few people here who have had their revisions from stomach stapling to the DS. I hope they'll be able to chime in about their experiences.

Don't let money stop you from getting the WLS you really want. This is the rest of your life--not a good place to skimp.

There are some smart folks on here who can give you guidance on trying to get your insurance to pay for the DS. The thinking is that if the insurance company agrees that you require WLS, then the DS should be paid for too. You may have to fight, but it could be possible, depending on what type of insurance you have.

You may also want to post specific questions to the revisions board on OH, too.

If that doesn't work, there are some great companies (like Starbucks) that will give you great health insurance in exchange for good, honest work at a part-time job. I was about to go that route when my hubby changed jobs and we got better coverage. Yes, the DS is THAT good that I would have taken on another job!

Good luck!

Nicolle 

Thanks for the great response!!!

I always have a hard time answering this type of question, because it is so personal and only you can take everything into consideration and make the decision for yourself.

That being said, I avoided a paid for RnY for longer than 15 years, for various reasons, but the big one being that I knew that I would not be happy with the post-op life.  When I found the DS, I couldn't get the surgery scheduled fast enough.  My post-op life is more 'normal' than I could have ever imagined.  With the advantage of hindsight -- yes, I would have paid for this outcome with my own funds.