Help with revision

I have lap band and am looking to get revision to VSG or Gastric. Insurance has denied it stating its not medically required. All information and advice welcome. I'm also looking for a board certified surgeon in Missouri or Illinois. 

I need to ask a lot of questions so that we can help. I only come on here once a day or every other day, so I may not respond quickly. How long have you had the lap band? What insurance do you have?  Who submitted the request for surgery, since you're looking for a surgeon? I saw your BMI on your profile page, so why do they not feel it's medically required? Have you used the search (upper right) for a Bariatric surgeon?

I've been denied twice on a revision, so I can empathize with you.  Donna 

Like the OP said there are questions to answer so we can help. Did you make sure your insurance covers revisions at all? Many don't because they only will cover 1 surgery per lifetime. Is your band causing problems or illnesses? I ended up having to self pay for my removal even tho my band was causing awful GERD and heartburn. My insurance did not cover bariatrics and I couldn't stand the pain anymore so I just had to make the decision that I'm more important and worth having my life back to half way normal. I still have problems from the band that will never go away so if you are having issues you have to get it out!

Hello, yes my insurance covers revisions if it's medically necessary (not just for obesity). I've had horrible acid reflux since port replacement in 2011. It's either to tight where I can't eat any solids or to loose where I can eat anything. They have been unable to get me into the "green zone" since the replacement. 

Did you submit the request, or a surgeon? My "team" told me that if I submitted my request it would most definitely be denied.  My surgeon put in the initial request and it was denied. They appealed and got denied, then re-submitted with different codes (I don't understand that part!) and got approved. I remember in the beginning of my whole process, I was told my insurance didn't cover bariatrics.  I only went into the revision process because I had severe acid reflux and a hiatal hernia that my doctor refused to fix without removing the band.  Good luck to you, I hope you get approval! 

I had the band in 2007.  Lost 100 pounds and gained most of it back.  I had it removed in August 2014 after it slipped.  I was a self pay to get the band but my insurance did cover the removal.  I was denied for RNY surgery twice before I was finally approved.  It was a 2 year journey but I was approved on Good Friday and had surgery on 5/18/15.   So far things are going good.  It was a long hard process but I am grateful I persevered.  I thought about the sleeve due to the Mal-absorption with the RNY but then decided the sleeve is more similar to the band and that didn't work so maybe I need something more extreme.    I was able to eat around the band.  How crazy is addiction?  After spending $17,000 I still failed.  I have learned that I need to deal with my feelings and lots have come up since being on the liquid diet.  I now am in therapy to deal with that stuff so I have a better chance of success this time.  Good luck with your journey!!

Oh yes I never saw the so called green zone either! Few people ever do I think that is just something doctors made up! As long as your insurance covers revisions you should be able to get it then. You may have to appeal it, call and find out what they require for medical neccesity you just may need more information to send them. Good luck hope between you and a new surgepon you can get it approved.