BCBS Appeal Denied for VSG

Got my letter from BCBSNC yesterday.  Damn I thought my letter and documentation was so good, there was no way they could dispute the evidence I submitted! The letter says
"A BCBSNC Associate Consulting Medical Director has reviewed all of the documentation submitted and denied the request for benefits as investigational and not medically necessary. The Med. Dir. stated as per BCBSNC, CMP, the proposed surgery is considered investigational and therefore not medically necessary and the denial should be upheld."
My next step is a 2nd level greviance by an independent external community /provider review panel who are not BCBS employees.

I am just disgusted and hurt. I guess all I can do is submit my original appeal information along with a 2nd appeal letter to plead with the 2nd level appeals people.
Anyone have any ideas on what to put in the 2nd appeal letter? 

Have you considered the Lap Band or realize band?  I am only asking because I also have BCBSGA, and when I went to the seminar I was also interested in the sleeve, however my surgeon was honest and stated that he has not had very good rate of approvals with the sleeve since it is still considered investigational.  The surgeon explained that I would probably get a approved for the band.  He was right, I was approved after about 1 month of the forms being submitted.  I know it is very frustrating, this is just a bit of advice.

Yes, the band or DS will be my next option if appeals fail. Funny thing is when I started this, they would not approve the band for BMI's over 50. In Jan 09 they will begin covering them.

 I hope that your appeal goes well and your insurance will approve. We all should be able to get whichever surgery we want. We are the ones who have to live with it for the rest of our lives not them.
Have you checked out the DS board? The DS offers restriction (the first part is the VSG) and the second part, the switch, offers malabsorption. Malabsorption helps patients lose more weight and keep it off long term. Some people are afraid of malabsorption but the RNY has malabsorption too and the majority of problems people have with the DS (i.e. malnutrition and vitamin deficiencies) is mainly a compliance problem. I hope everything works out for you with the VSG but if the DS is your back up plan I'd say you are doing pretty good.

Most insurance companies consider the VSG investigational and will deny it.  You would have much better luck choosing another type of surgery.