Anthem BC BS revision

Has anyone out there had BC BS pay for a revision? I had the DS 8/19/02. I started at 404 and am now 305 still, SMO. I'm seeking a revision after multiple tests proved that my alimentary limb was extremely too long and never measured. Has anyone had BcBs pay for a revision of any kind? Thanks in advance, Kim

can you please tell me what the DS is? Is it slow like the band?

taken from another page here on OH.com About the Duodenal Switch Duodenal Switch surgery was originally designed for patients with bile reflux gastritis but has been developed as a very effective weight-loss surgery. It combines both restrictive and malabsorptive elements to achieve and maintain the best reported percentage of excess weight loss, 80-85% with little or no regain. It is an especially good surgery for the super obese. It differs from the common gastric bypass in several ways. In a gastric bypass operation, portions of the stomach are bypassed. In the duodenal switch, however, about 75 percent of the stomach is removed, leaving about a 7-ounce stomach. The most important feature of the operation is that it rearanges the small intestines, so that the food is diverted and only absorbed in the last 75-100 cm, otherwise known as the "common channel." The section of the intestines that carry the food from the small stomach does not join with the section carrying the digestive juices from the liver until very far downstream. Because of this, the amount of fat and calories that are absorbed from foods is greatly reduced. Since this surgery has such a high malabsorptive degree, to prevent deficiencies, a high-protein diet and lifelong vitamin and mineral supplementation are necessary. Since the outlet valve (pylorus) between the stomach and small intestine is left unchanged, this surgery will not produce the "dumping" syndrome as seen in gastric bypass operations. The risk of marginal ulcers, stoma closures and blockages are also eliminated. With keeping the pylorus intact, a more-normal absorption of many nutrients (including protein, calcium, iron and vitamin B12) than is seen than after other gastric bypass procedures. In addition to a dramatic and permanent weight loss, studies have shown that duodenal switch leads to the improvement of diabetes. This is achieved by correcting the way the body handles carbohydrates, with no need for insulin or other hypoglycemic agents. It also can correct severely high cholesterol. There are advantages and disadvantage with the duodenal switch. Duodenal Switch Advantages More "normal" absorption of many nutrients than with BPD, including calcium, iron and vitamin B12 Better eating quality when compared to other WLS procedures Eliminates or greatly minimizes most negative side effects of the original BPD Essentially eliminates stomal ulcer and dumping syndrome Duodenal Switch Disadvantages Greater chance of chronic diarrhea Significant malabsorptive component More foul smelling stools and gas As with any surgery, there can be complications. This list can include: Deep vein thrombophlebitis 0.7% Non-fatal pulmonary embolus 0.5% Pneumonia 0.5% Acute respiratory distress syndrome 0.25% Splenectomy 0.9% Gastric leak and fistula 2.0% Duodenal leak 1.5% Distal Roux-en-Y leak 0.25% Postoperative bleeding 0.5% Duodenal stomal obstruction 0.75% Small bowel obstruction 2.0% Some useful links: http://www.duodenalswitch.com/ http://www.annecollins.com/lose_weight/duodenal-switch-bpd-ds.htm http://www.homanmd.com/ds.htm http://www.obesitylawyer.com/duodenal.htm http://www.nlm.nih.gov/medlineplus/ency/imagepages/19500.htm http://abclocal.go.com/wtvd/health/022103_NH_dssurgery.html http://www.drhaicken.com/bpdds1.html http://www.foodanddiet.com/NewFiles/duodenal-switch.html http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=9717420&dopt=Abstract http://www.asbs.org/html/story/chapter3.html http://www.cpmc.org/advanced/lapsurg/surgery/procedures/lapsurg_obesity.html

wow Vicki you are so well read on this. Thank you so much. I dont get the dumping thing do you? Unfortunatly I can handle sugar. Nothing seems to bother me except Chinese food and steak. Thank you so much for letting me know about this. Cindy

NOT well read, just know where to find things on the Obesityhelp.com site Sometimes I dump, sometimes I do not. Depends on the day and the pouch. Most the time I can handle sugars, but I DO NOT "QUOTE" eat them all the time nor daily. I just notice I can because of salad dressings, that I use like dip for chicken, BBQ sauce... can't do the honey kind though OMG unless it's an extreme light coating (and my momma put it on EVERYTHING Monday Even when I asked her not to ) I do NOT do soda's, I have had a cc cookie.. mmm still tastes the same.. anyways do not buy them though! Well bought my kid a snack pak of them for the ballgame we went to. Have you seen the price of munchies at these places? OMG WATER $2.50 and this is a minor league team, (so I sneak stuff in :-X) But I will not lie, I have had "bites" of wrong foods, but 1 or 2 bites and the craving is gone.. unless it made me 1st.. then I'm more than done I'm real careful that I don't dump though, because when I do then I am unable to eat anything else for the day.... which can through my whole day off if I dump early. So I just say most times to stuff I know is not good for me. I am able to eat just about all meat, some pork gives me problems from time to time, even the leanest cuts. Oh well only Pouch knows. and today I'm going to my Dr's AND I know I'll be on that scale, so I haven't eaten much so far today, B- CIB NSA w/skim milk 3 slices turkey bacon = 20g's of protein, 16 oz water, S- Profect 25 g's protein more water, 2 crackers... don't want to weigh myself down too much, been a couple days since I could ... well again. bwahahaha Oh Sorry TMI! hugs

lol.I go every 4 days . TMI I know

Every BC/BS plan is different. Every employer chooses different stipulations for each policy. You will just need to call the member services number on the back of your card to see if they will cover the revision. If you don't have a direct exclusion on your policy for the surgical treatment of weight loss, your surgeon would have to submit a pre-determintation to prove medical necessity(it would still be BC/BS's discretion). If there was truly a problem with your first procedure, then the likelihood of them approving it is higher. The procedure code for revision surgery is 43848. You can call BC and specifically ask if that code is covered. Hope this helps.