Need help with appeal!

anyone done an appeal and won for a revision??  I had a VBG converted to a RNY in 2004, for severe GERD. My new surgeon was planning on placing a lap band over my pouch and felt when I spoke to him we wouldn't have a problem getting this approved.  Ever since I have had absolutely no restriction.  My new surgeon did a  uppper GI and an EDG and stated I have an enlarged pouch and stoma.  BC/BS is stated criteria for medical necessity was not met, per medical policy subsequent bariatric procudures in patients *****gain due to failure to comply are not medically necessary.  I have 2 bulging disk in my back, oseoarthritis in my knee, PCOS, reactive hypoglycemia. ANYONE with suggestions would be appriciated. Thank you

This should be easy to appeal. If the original surgeon made your pouch and stoma too large just get the xrays from your leak test post op and get your current xrays and submit them to the ins co proving it was not done correctly from the start.

Have them scanned and you can just submit the CD and keep the xrays.