insurance will not cover ds only gastric bypass please help

Hi,

  I had the gastric sleeve back in 6/2011.  I was told by another surgeon it was not done right so I need to have a revision.. but my insurance will not pay for the ds.. it will only pay for the gastric bypass... Please help in any way if anyone has any suggestions on how to appeal this decision and for me to get the ds approved...thanks..

Do you require NSAIDS cause the RNY is contraindicated for that and would be a good reason to get the DS.

Liz

yes i do take a stomach pill for the acid reflux  i had the originial surgery here in pa and i found a dr Greenbaum in nj that is going to do my revision..

Acid reflux is not what one would use an NSAID for...NSAIDS are for arthritis or pain that does not respond to tylonel or aspirin. If you have arthritis or have a strong family history, it's a good reason for the DS.

Liz

no not on that then,, i have diabetes, high blood pressure, thyroid, asthma i only lost 45 lbs with the first surgery.

Do members of your immediate family have arthritis (most of us do) or a history of migraines, or back issues/knee pain, etc???

I did have back surgery back in 1992 but i am not on any medicines for it

Maybe not now but who knows what the future brings. I also had back surgery and still needed NSAIDS.

Liz

The DS is the most effective form of WLS for treating diabetes. Try that argument. Also, you already have half of the DS. Adding the intestinal portion should be less risky for you than converting to a less-effective form of WLS.

If necessary, hire a lawyer.