Revisions

Wanted to know how so many of you are getting approved for RNY to DS revisions? Are they medically necessary? Are your insurances covering the procedures? I am in the process of trying to get a revision from RNY to DS and I am getting nowhere. Can those of you that have had the revision, please tell us how you did it? Thanks.

RNY to DS is not a revision it is a conversion.  BCBS will pay for a conversion (revisions) if it is medically necessary.  No insurance will pay for NOT medically necessary surgery, unless you have a cosmetic rider.  No one will be able to answer your specific question as your benefits are individualized by what your employer wants to carry and that information is in your subscriber agreement, which you should know way before you apply for surery.

I have BC/BS insurance and I know they will cover it if it is medically necessary. I just had the barium swallow and the doctor has not reviewed it yet. The next step is a EDG. I know what is required by my insurance, I was just wanting to hear from others to see why they were getting revisions or conversions.

I was approved for revisional surgery for RNY to VSG with SADI procedure. I was a medical necessity because I have had chronic bleeding anastomotic ulcers that stopped responding to medical intervention. Unfortunately, because of some orthostatic BP and O2 issues during surgery, the procedure was cut short after the VSG conversion and large hiatal hernia repair. I am not sure that DS would have been approved because I did not actually have a weight gain. 

Lisa

Lisarn1 thanks for the reply, how are you doing since your surgery?

Thank you for asking. It has been a rough recovery. Although I had my revision in Oct, I am still recovering from my thoracic surgery and all the other tubes and procedures they did. I am hoping to be back to work on Dec. 15. I am still having trouble with progressing my diet. I'm still mostly on liquids and semi soft foods, but can, on occasion, eat more dense foods. 

My Revision surgeon's office did all of the paper work. It was medically necessary for me to revise. It was complete failure of RNY surgery (not me).  He scoped me and I had a micro pouch and stretched stoma. Food was dumping into my lower intestine. 

Firs find a revision surgon. dsfacts.com will point you in the right direction.

Good luck

Hi Whit, thanks for the reply. How was the revision surgery? More or Less pain than the orginial RNY? Was yours lap or open? How long were you in the hospital?

Surgery was rough for me. It was open but it did not hurt not at all. The incision was numb. I was in the hospital for 3 weeks. Complications. Recovery was to difficult part for me. But now 2 years out and 117 pounds and a size 2 I would do it over in a heartbeat.