Los Angeles Docs Revision RNY to DS

I had Open RNY in 2001 at weight of 247 now I am lingering up and down between 192 and 200 at 5'5 height. I would like a revision to the DS procedure. I have had a tummy tuck and would like to ave it done LAP . I have Cigna HealthCare and revisions are covered under mu plan.

hello -  I, too, have CIGNA and was just approved for revision surgery.  I had the SRVG back in 1997, which has since failed, and am now going for the DS.  Depending on your plan, CIGNA will probably deny the DS citing is "investigational/experimental" and you will have to prove medical necessity for a revision.  If they approve you for a revision be prepared to fight tooth and nail for the DS.  You will have supply a lot of information proving the DS is not investigational/experimental and will probably need to go all the way to an external appeal process, which is what I just finished.  But, I'm living proof that if you stick to your guns and don't give up, you can win!  If you need any information or help, please let me know. Take care and good luck!

Found Dr. Quilici in Burbank. Thanks for your help.  My insurance will change at the end of the month to Aetna PPO. However I meet with Dr. Q  on Wed. 

You certainly do not want a surgeon who hasn't done a lot of revisions from RNY to DS to touch you!  It's the most complex, hardest surgery of them all.  Here are your DS surgeons in CA:

http://www.duodenalswitch.com/surgeons/surgeons.html#ca

CALIFORNIA

Delano

* Ara Keshishian, MD, FACS (photo)
E-mail: [email protected]
Contact: Dawn Keshishian, RN or Dee Tinkle, LVN
Phone: 661-725-4847 or 800-816-6647 (toll-free)
Delano Regional Medical Arts Building
1205 Garces Highway, Suite 303
Delano, CA 93215
http://wwwdssurgery.com

Los Angeles

Peter Crookes, MD (photo)
Howard Kaufman, MD (photo)
Lelan Sillin, MD (photo)
Contact: Maria Harrison
Phone: 323-442-6219
University of Southern California
1510 San Pablo Street, #514
Los Angeles, CA 90033
http://www.surgery.usc.edu/foregut/bariatric/

San Francisco

* John J. Feng, MD, FACS (photo)
E-mail: [email protected]
Phone: (650) 685-2959
Fax: (650) 685-6754
Advanced Laparoscopic Surgery
Minimally Invasive Surgery for Obesity
Crystal Springs Surgical Associates, A Medical Group, Inc.
450 Sutter Street, Suite 1400
San Francisco, California 94108
http://www.CrystalSurgical.com

* John D. Husted, MD (photo)
E-mail: [email protected]
Phone: (415) 561-1310
Fax: (415) 561-1713
Laparoscopic Associates of San Francisco
2100 Webster Street Suite #518
San Francisco, CA 94115
www.johnhustedmd.com

* Gregg Jossart, MD (photo)
E-mail: [email protected]
* Paul T. Cirangle, MD, FACS (photo)
E-mail: [email protected]
Phone: 415-561-1310
Fax: 415-561-1713
Laparoscopic Associates of San Francisco
2100 Webster Street, Suite 518
San Francisco, CA 94115
http://www.lapsf.com

* Robert A. Rabkin, MD, FACS (photo)
* John M. Rabkin, MD, FACS
Contact: Barbara Metcalf, RN
Phone: 415-668-3200
Pacific Laparoscopy
2250 Hayes Street, 3rd Floor
San Francisco, CA 94117
http://www.paclap.com

San Mateo

* John J. Feng, MD, FACS (photo)
E-mail: [email protected]
Phone: (650) 685-2959
Fax: (650) 685-6754
Advanced Laparoscopic Surgery
Minimally Invasive Surgery for Obesity
Crystal Springs Surgical Associates, A Medical Group, Inc.
101 South San Mateo Drive, Suite 302
San Mateo, California 94401
http://www.CrystalSurgical.com

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Hi Pamela, How are you able to have a revision since your BMI is under 35?  I was wondering because that is what I am struggling with now. Im 5'6" and I currently weigh 197lbs. 

While I'm not an insurance expert, I've heard that revision surgeries can be approved for other reasons besides BMI.   If there is evidence of mechanical failure of your original surgery or if your co-morbids are the bad ones...... (diabetes, high blood pressure, sleep apnea).  It could be any of those reasons with a growing BMI. 

As I said, I don't work for the insurers, but that's my best guess.