What did insurance require from sleeve to GB?

MammaKathy
on 7/5/18 5:06 pm

I was sleeved on 8/17/16, and I only lost about 35 lbs. My current BMI is 30. I have had severe reflux ever since surgery. I had a recent barium swallow that showed severe gastric reflux. My surgeon wouldn't do anything about it bc I have horrible adhesions from previous surgeries (pancreatic and kidney). I know she felt it was too risky. She is a good doc, but very young. I am now two years out, and I the GERD is getting worse all the time. I went to see a more experienced surgeon this week, and he immediately said I need GB. I agreed as long as once he gets inside of me, if it looks too dangerous, don't do it.

Anyway, what tests did your insurance company require to approve the revision? This won't be for weight loss, but for GERD.

Thank you!

stacyrg
on 7/6/18 8:32 am
VSG on 05/12/14

My barium swallow did not show any GERD, so my surgeon ordered a manometry and pH testing which showed I had acid levels 409% higher than normal. I was approved for a revision in a day

MammaKathy
on 7/7/18 3:00 pm

I am hoping insurance doesn't make me do more testing. I guess I was hoping to hear that the barium swallow was enough for someone else to get surgery covered. lol

MarinaGirl
on 7/8/18 12:51 am

An EGD gave the surgeon the info he needed to submit a request to revise me to an RNY (due to reflux), which insurance approved. Now I'm waiting for the office admin to call back with a surgical date.

LynneT
on 8/21/18 1:35 pm
Revision on 03/21/17

My surgeon applied on the basis of symptomatic GERD and a barium swallow and it was approved. I did have a lot of other issues, but he didn't need to use them as basis for the revision. I'd already been through a failed fundoplication and hiatal hernia repair after my VSG in an attempt to solve the GERD without a revision. Like you, I didn't need the revision for weight loss.

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