band to sleeve revision vs. removal then 2nd surgery

Hi Everyone,

I had my first consult on Friday for a band to sleeve revision.  I really liked my doctor and nurse but was a little taken aback by the financial coordinator.

I have Cigna.  I would really like a band to sleeve revision performed at the SAME time.  Per the financial coordinator, Cigna will not pay them for removing band and then sleeve performed at same time.  They can only submit for one or the other.  She said the preferred way to handle it is to first remove the band, then after NUT counseling, psych, etc, perform sleeve 90 days later.  She said there was no guarantee I would be approved for sleeve after band was removed.  I was kind of upset hearing this.  When I finally got in to see the doctor, I stressed that I preferred to have revision done at the same time.  He said they could try to work something out and took notes.  

Anyone else have this issue?  I was a bit emotional yesterday after dealing with the financial coordinator.  This was after she initially told me Cigna would NOT cover WLS for me, that I was excluded.  I insisted she call them back and after I got a little weepy, she did.  She then said "this is my lucky day" and I was NOT excluded.  It was an experience, let me tell ya.  Later in the afternoon, I called back the coordinator to chat a bit but I feel like I am missing something.  I am going for additional tests and the nurse is going to call me.  I think I am nervous about the whole process.

Did all of you who went from band to sleeve have removal surgery, then 90 days later the sleeve surgery?  Sounds like this can be quite a process...  I guess I was maybe not being reasonable to think I could just do both at same time in the next month or so?  What is your experience?  Anyone have it done at the same time?

I only had mine removed and I had to pay for it so can't speak from personal experience. However it is very common to do it in 2 surgeries because the band can cause such terrible damage that it takes the stomach time to recover and of course they make more money if they do 2 procedures. Some docs do it all at the same time and others prefer to do it in 2 separate surgeries, kind of a matter of personal preference for the docs.

Gotcha Hislady, thanks. That does make sense.  Hopefully my doctor will be willing, I will have to wait and see I guess.  I don't know why I thought it would be more common for 1 surgery.

Thought of another question, not sure if I need another thread...  My BMI at weigh in yesterday was 40.4.  That is real close to the minimum without comorbidities.  Do I have to be careful to not lose weight until a certain point?  Not sure if I drop under 40 if that would be okay.

Hi, I am going in for revisional band to sleeve in the morning. Most doctors wait to give your body time to heal I asked my doc due to my demanding job if I could have this all done at once and he said that it would be lengthy surgery (due to the scar tissue) but because I have no health concerns and my bmi is on the low side that he will do it all at once!!! So I will let you know more when I come home :) 

I lso had the same type of scares with my insurance company but once it was submitted there was no denial:)

My BMI is 39.8 so you should be fine

Good luck tomorrow!  Keep me posted!!!

I believe you will do so much better if you did 2 surgeries.  I waited 6 months after my Band removal.  I chickened out on a vertical sleeve PLICATION on the operating table minutes before they gave me the anesthesia.  I mean I waited 6 mos for the approval for the hospital board to approve that revision  as the Plication was not being done then (only 2 studies 1 in Ohio).  and then I said please just do only a band removal.  So I could have had my revision at the same time I had my Band removal.  Thank God  I did not.  I think allowing my stomach and esophagus to heal was the kindest gift I could have given myself.  

Knock on wood, things can change but I have had no issues at all - no acid reflux issues at all.  no swallowing issues or anything (I mean I have not lost all of my excess weight but I feel so normal).  I had a history of esphogael dilation so releasing that high pressure from the Band was a blessing.   

all best.  Be patient!

My doc says he likely could do the surgery in 1 shot.  I'm not sure which is better.  I'm struggling with making my decision to revise.  I have to go see him today and feel like if I'm going to do it, I need to decide now because of when I would prefer to do it.  The other day I was 100% sure I'm going to revise, today I'm apprehensive.  I don't even know what my insurance will do.  If they won't pay for the band to be removed and revision,  I won't do it.

Good luck!

In the same boat. My doc says he can do both in one shot. I've had SO many problems with my band, I'm worried about how it will go if I do both at once. That maybe I should let my body recover from the band first...so hard to know. Every surgeon seems to have different ideas!