Hoping for DS Revision in New Year

I had my gastric by-pass roun-en-y March 2000 and in 2008 I slowly started to gain my weight back and no matter what I tried couldn't lose it. I have tried (this will be my 3rd time so maybe this will be the charm), before to have a revision done but have been denied twice by Tricare as they say the coding wasn't correct (it has to be medically necessary as they only pay for one gastric by-pass a life time). What is interesting each time when I have had an EDG performed since my surgery by other doctors they have each said my pouch was larger than normal and NOT due to stretching but larger due to the size the surgeon made it when he performed surgery. I have not stretched my pouch this is NOT my problem.  

That is a good thing and a plus if I am denied and have to appeal. My question is has anyone had to have a revision? Had Tricare, been denied and had to appeal? If so how did you go about it? 

I'm trying to prepare myself in case I am denied once again so that I am ready to appeal as soon as I get this denial so I can write up and send all required documentation with my appeal letter. Any information anyone (even private insurance who had to appeal) can assist me with would be greatly appreciated.

I will be having the DS revision and I am extremely excited to begin this new phase of my life. I have been eating healthy and going to the gym in preparation for the revision. I want to thank you in advance for your assistance. Thank you so much.

Dot

Had my bypass Dec 2008 and a revison with band over bypass on 12/16/15 this year. I have BCBS and it was approved then denied after the surgery. It is all approved now and my DRS office fought on my side with the insurance. See if you contact Tricare if you can prove your 1st surgery failed due to your stomach pouch stretcing out (Mine stretechd from a 9 to a 16 in size) or anything else - weight gain, other illness associated or new now, and then show your journey to try to lose weight again. This is what the insurance is looking for in my case. I wish you the best of luck!!

RNY to DS is a very complicated procedure and there are only a few surgeons worldwide who are qualified to do it.  Some surgeons are doing a procedure called the SADI loop.  Good luck with your revision.