Denied

Weight isn't the issue. I had my surgery 5 years ago and have lost 200 lbs. I've been at my current weight for 3 years. 

Can I add mental anguish/depression to my appeal?  

how about lower back pain

absolutely...... your mental status should also be considered when reviewing all of the reasons for your appeal. Although I doubt it will be the sole deciding factor. Hopefully they will look at the entire appeal as it applies to their guidelines for determining medical necessity.

Just playing devils advocate here....

Do you have 6-12 month documented rashes that do not respond to conservative treatment? have you visited a chiropractor for back pain? You weight hasn't fluctuated more than 5 lbs in the past 6 months has it? just checking.

Definately give the carrier a call to request in writing their medical guidelines for necessity.

Kendra... I feel your pain.. I too was denied even after an appeal. My only suggestion is that you contact your insurance company and obtain their medical guidelines for the procedure you were requesting. It may be something as simple as you didn't meet the weight loss guidelines or time guidelines (ie: x amount of months post op or x amount months at a weight plateau)..

I wish you luck...

 

That is so understandable!! I wish you the best of luck in your appeal!