Revision from Lap Band to _________?

Has anyone had a revision from a Lap Band to any other WLS, that has been approved by BCBS, not because of serious complications, but because of NO or SLOW weight loss?

I'm trying to get a revision from my band to the DS.  I've had my band 22 months and haven't lost a single pound - I'm not talking losing and then gaining some back - I'm talking NO WEIGHT LOSS SINCE SURGERY!  I know that many have revisions because they have reflux, slipped bands, erosions, flipped ports, etc.  I only have nausea and vomiting almost daily, and NO weight loss.

I'm worried that my insurance may not approve this revision, because they may not consider it a "failed WLS", without any serious side effects.  

And, of course, I want the revision done yesterday.  I don't want them to make me go thru 6 consecutive months of documented "weight loss attempts" - I think having the band 22 months is enough.

Anyone been approved for a revision without serious complications from the original WLS?

I may be putting the cart before the horse here, but I'm paranoid that they're going to deny me!

Stephanie

I can't help you with the BCBS Insurance but is it possible to call and ask.  I know I had a similar problem with my band and I didn't have it as long as you, about 14 months and I ended up gaining weight so don't feel alone.  Mine was removed and covered by my insurance but I also had acid reflux (chest pains) and was put in the hospital for observation to make sure it wasn't the heart first.  I know I don't want to "jinx" it myself as I'm waiting not only on insurance to cover the RNY but also my surgeon to approve me also.  Good luck to you brandyII.

I`m not qualified to comment on US insurence requirements, my family lives in Germany since many years, but daily vomitting and constant nausea should qualify as serious complications, shouldn`t it?! It`s unacceptable to live like this.

All tthe best,

J.

I'm not familiar enough with BCBS, but there are many revisions on the DS board, and there are people there are very experienced with some of the main insurers, so you may want to cross post this over there, to get a few more peepers focused on it. Good luck.

I did not have any serious complications with my band.  But I did develop reflux after a few fills and I did not lose a lot of weight.  My surgeon recommended a revision and I jumped at it...lol.  I was revised to the RNY and have done very well. 
Originally the request was turned down by my insurance company because they failed to send in the letter of medical necessity...an oversight. My insurance is Harvard Pilgrim Healthcare HMO so I have no experience with BC/BS.  Harvard was pretty good....they paid for two weight loss surgeries for me. Once it was sent in I got approval right away. 
I did have the vomiting almost daily but that was because food specifically meat would not go down....I slimed all the time.  I was in denial for quite some time about my issues.  I had my band for 24 months almost to the day.
I think your DS surgeon's office can write up a letter of medical necessity to get your approval.  You have to have a real valid medical reason to get a revision. I am not sure your problems are enough. Have any other health issues gotten worse since you were banded? Have you had your band completely unfilled to see if that cures the problems?
I know a lot of people in my neck of the woods that got the band and truly regret it are now having issues or little weight loss.
Good Luck!

I have BCBS PPO too.  I have not had my revision yet.  BCBS will not approve for the revision unless there is complications or technical failure.  Since you have complications, I'm sure your will get approved for your revision.  

I had an upper GI and was told that my band is normal, no technical problem.  However,
I had lost 13 lbs then gained 17 lbs.  The band does not work for everyone.

Any way, my surgeon is not in the network.   I have no choice but to self pay to get my band out and get an RNY.  The surgeon wants me to lose 10 lbs before I have the revision.   That's what I'm doing right now, working on losing those 10 lbs. 

I sure hope things work out for you.    

I had a revision from lap band to DS.  I was having problems with my band but I am not sure that is why BSBC approved my surgery or not.  No one seemed to listen or be that interested in the fact the band was making me throw up.  I included that as part of my appeal but I do not know what the deciding factor was in reversing the decision.  I also had gained back all the weight I lost with my band.  When I was denied I appealed with a very very long appeal letter.  My appeal was granted a few days later.  I also actually found a FDA study that stated that the land is not effective long term and in some cases does not work at all.  http://www.fda.gov/bbs/topics/ANSWERS/2001/ANS01087.html  The last paragraph is what I quoted in my appeal letter. 

I have no idea what it was that changed their minds.    I hope this helps at least a little bit.
Dawn

Dawn - Thanks for your response - yes, it does help.  Interesting study you referenced - found out that I'm among 5% of people with the lap band - neither gained not lost.  Not really the statistic I wanted to be, but what am I to do???

I'm glad you shared your story with me, as far as being denied and sending an appeal letter.  It gives me great hope to know that if I am denied - that doesn't mean it's final.  I will appeal any denial, if I'm put in that situation.  So, I may be contacting you to get more info on what else you included in your letter - if you don't mindl

Thanks again and take care,
Stephanie

 I have BCBS PPO and they would not do a DS revision saying it was experimental, so my doctor did the RNY instead. I did have a slipped band and it needed to come out. 

Crap, crap, crap - that's not what I wanted to hear.  Is your BCBS of Texas?  Mine is MI - don't know if that matters or not. 

I did call my BCBS before I went for my consultation and gave them the procedure code that the office had given me for the DS.  They said that the code was an approved service, providing that I meet all the criteria, blah, blah, blah - which I do, except I'm not sure about the 6 consecutive months of documented weight loss attempts. 

I guess I'll just keep my fingers, toes, arms, and legs crossed - well, maybe not my legs - too fat for that! 

Thanks for your response - it is appreciated.

Regards,
Stephanie