MEDICARE COVERAGE FOR REVISION FROM GASTRIC SLEEVE TO RNY.

My surgeon has told that due to spontaneous gerd I need to be revised to an RNY. My BMI is normal and really do not want to lose any more. Has anyone had problems like this and Medicare pay for the revision?

There are lots of different medicare plans and we can't tell you if the procedure is covered under your specific setup. Call them (1-800-MEDICARE) and they can help talk about your particular coverage.

Several people on OH have had revisions for GERD while at a normal BMI and it hasn't been a problem to maintain their current weight.

I just noticed that you were converted from the sleeve to RNY. How are you doing with the RNY? Also, have you had any problems or a lot of pain? Is the GERD gone?

You don't know how much it means to hear from someone that's already gone through it.

Thanks!

I am doing great with the RNY and the GERD is completely gone! I've lost almost 30lb since surgery day, which seems like really good progress.

My sleeve was very stretched before the revision and I didn't have to be as careful about chewing my food, so I've had a hard time adjusting to eating very slowly. I've had a lot of times already when I got food stuck and had to make myself gag it up, which is pretty miserable. Hopefully I'll learn eventually.

Overall I think I'm doing pretty well and I'm very glad I had the revision!

Glad to hear that you are doing well! Congrats on the weight loss!

I'm below my goal weight right now and I'm having to take B12 injections weekly to have some energy. Hoping the RNY will get me all fixed up.

When I had my hernia removed earlier the doctor told me my sleeve was cut larger than they cut them now. I had mine over 12 years ago. He said now they make the sleeve a lot smaller than mine, but I had no problem losing weight. I lost over 100 lbs and it's pretty much stayed off all 12 years. I've only gained once when I had to have a lot of steroid injections, but as soon as they got out of my system the weight came back off.

I'm hoping the RNY recovery goes as well as my sleeve recovery. I'm looking forward to no GERD.

How far out are you? Are you able to eat pretty normal now?

Thank you for the response! I've decided to go with traditional Medicare. My surgeon is at the Mayo Clinic. The Clinic gave me the procedure and DX codes. I called Medicare and they told me the same thing no PA is required and if the doctor submits with documentation of medical necessity there shouldn't be any problem. They even told me what my out of pocket would be.

My surgeon's letter to my current insurance states that due to the spontaneous reflux, I am not getting the nutrients to sustain life. So, I think I'm covered there.

I think I'm just very nervous about having the procedure and I'm a worrier about money too. Bad habits I know. I'm waiting on the surgeon to schedule my date. I'm hoping to have it early December. My surgeon is out of the office until late fall.

Thank you!