pannectomy with Blue Cross

I have blue cross ppo and they pay for pannectomies after gastric bypass.  I have not had any rashes and wonder if anyone else had a pannectomy through blue cross without having any complaints of rashes etc.

Thanks folks!

Yep, got mine covered after an appeal and I had no rashes. Had back pain, said panni was hindering my continued exercise which was important to losing weight. I had a hernia repair done w/ my RNY from a previous gallbladder surgery, had pain in the area from the panni hanging and pulling down. My panni was hanging over the mons area and the extra skin and pressure caused deep sebaceous cysts that were very painful. Can't remember what else I said in the appeal off the top of my head or what my surgeon said. But I do know that he did say in his opinion it was medically necessary and the skin was deteriorating.

Sonya

Sonya,

Thanks for the reply.  I have printed out all the replies I received to take to my appt on Tuesday.  I am hopeful the doc will be helpful.

Debbie

I have HMO Blue and had the panniculectomy covered with no rash without any issues. They approved it without delay. I think that I met the weight loss amount and maintained that loss for over 6 months. I really don't know what their requirements are, but my PS sent pictures and the request for me.

Martha

Thanks for the reply Martha.  All of this info will be helpful when I see the PS on Tuesday.

Debbie

I had BC& BS of Massachusetts. They covered my panni removal but I opted for full anchor tt.. which was $3500 extra.. and I got the Explanation of Benefits from BC&BS and they paid out 17,000 for just the panni removal.. not including hosp stay etc which came out to a total of $21,000 + change.

oops getting back to the question  I had no rash my panni hung over the pubic area which was a requirement.

Thanks for the helpful info Nat.  Much appreciated.

Debbie

i have medicare w/ blue cross blue shield was approved first time . I was shocked  still am !! do you have any ins if you do  I totally  would try to subit an auth for it first
good luck if you have any questions  feel free
hey we are in the same area!!
Denise

Thanks for the reply Denise.  Yes, I have Blue Cross PPO.  I am going to an approved PS on Tuesday, but have really never had any issues with the "overhang".  I just want it gone as it is too much.  I just didn't know if blue cross was going to expect me to have problems in order to authorize it.  I will leave it in the hands of the PS office to get it authorized for me.  My surgery was in Dec of 08.  I weighed 330 and am now 185.  Goal is 175 (I carry my weight really well).  I am still losing, so am hoping Blue Cross is not asking for a 6 month maintenance before they approve it.

Debbie