not really a revision???

tracyb330
on 1/19/08 10:49 pm - Temple, PA
Good morning everyone! I had a VBG back in June 2001. Less than 2 months later they took the band out because I was in the hospital 17 times and on a feeding tube. Since the took the band out there really isn't anything that would prevent me from eating. Now 7 years and 2 more kids later I want gastric. My insurance has a one and done deal. Even though I have a different insurance company now the Dr will send this in as a revision. My complaint is that it's not a revision if the first one was taken out, right. I am just scared that my insurance company will say no as soon as they see that one word...REVISION. Plus I heard that Highmark PPO blue Shield makes you do a 6 month diet thing. HELLO, I've been on WW that long and have been on a diet for my entire life. I just think that is mean to make us diet again for another 6 months. I just had to vent and if anyone had their VBG taken out and gastric done I would love to hear from you. I go for my consultaion with Dr. Boe this Thursday.  Thanks, Tracy
monicalindquist
on 1/20/08 3:02 pm - Euless, TX

Dr. Boe is awesome.  He did my revision.  Just let him know the insurance dilema.  He will understand.  He worked with my insurance to get it covered by including all my other issues and diagnoses.  Just ask him if he can call it Roux-en-Y and not a revision.  If he doesn't mention it, the insurance company will have no reason to look back into past records.  Good Luck!!

LosingSally
on 1/20/08 5:07 pm
Ask your surgeon not to list it in the insurance code for revision.
tracyb330
on 1/21/08 2:40 am - Temple, PA

thanks. I will talk to Dr.Boe about this and hopefully he will be able to help me. Thanks!

LosingSally
on 1/24/08 1:08 pm, edited 1/24/08 1:09 pm
Ask your surgeon to code it as a RNY, plain and simple. You have no band, so it's not a revision. It's simply a WLs you've never had, and is reccomended for you by your surgeon.
(deactivated member)
on 1/26/08 8:25 am - TX

If you have a one time only WL option with your surgery, you might want to look at the DS.  Many, many of gastric bypass and lapbanders turn to the DS because they didn't have it when they had their first surgery for one reason or another.  I (myself included) have heard many times revisions say they wish they'd known about the DS before their original surgery.

Good luck to you.

leslieanne729
on 1/27/08 1:42 am

Just a quick note to inform newbie’s searching for info on Revision surgeries....have you looked into DS?  It's an option overlooked by many.  Go to the DS forum on OH and ask questions....we have quite a few revised to DS from other WLS

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