Do I have a shot at revision approval?

http://www.bcbsga.com/medicalpolicies/policies/mp_pw_a053317 .htm This is a copy of my insurance policy. I'm wondering if I have a shot at getting a revision approved. I have a copy of my endoscopy saying I have a stoma of 3cm, but I'm thinking the insurance will rule this "due to patient overeating". It says the criteria for covering are a failure with the surgery such as a fistula, obstruction, erosion, disruption/leakage of a suture/staple line. I don't think I have any of these. When I had surgery, I weighed 350, lost to 225, then regained to 280. I then went on a "crash diet", including phentermine for a year and lost back to 230. However, I'm back to eating "normal" again, and I have seen my weight creeping back up again.....do I have a shot? Thanks! Jill

Would you be willing to share what caused the weight to creep back up?  Also, what do you consider to be "normal" eating?

I had an upper endoscopy that showed an enlarged pouch, and a stoma of 3cm. I consider normal eating, to be what I was eating before I went on the crash diet and starved myself!

Jill, I just had my revision approved for a DS with Horizion BCBSNJ Plus. I had a RNY in 2002. My stoma is enlarged. I had to requalify BMI 35w/ co-morbitties, Sleep Apnea,arthritis, stress fractures, Nuit. Eval., Pysh. Eval, Pulmo. Eval, Gallbladder test, letter of medical need from my PCP and Orthopedic surgeon. I also sent them WW books for the last 3yrs showing high BMI and copy of my gmy membership usage for 2 yrs to show I was compliant with diet. If you jump through the hoop they put out you have a good chance. I hope this helps you. Ciao,  Leslie I also had an upper GI

Hijack!

Congrats on getting your revision approved Leslie!!  Woo hoo!!