feeling defeated

I suspect the problem isn't with your insurance, but with your surgeon. Most surgeons do have a procedure they prefer to perform, and either consciously or unconsciously steer patients in that direction. Since you say your insurance goes by surgeon recommendation, the only reason I can see that they'd deny the Sleeve but approve the RNY would be because THE SURGEON wants them to do that.

Get a second opinion. Just because you've been seeing this surgeon doesn't mean you have to keep on seeing him or her. The surgeon works for you, not the other way around.

Keep trying to get it covered. I agree with you I would not have gotten RNY. I think I would fight them. Mine went right through. and I started out were you are. Hang in there. Don't give up. It is well worth the effort.

I agree with so many of the previous comments.  Don't give up.  Make getting the surgery approved a new goal or challenge.  Force them to pay by doing all the research you can with their own documents.  My doc had a different list , base on Insurance company, of things they knew had to be done to get me approved.  One of the most important item to justification from your primary care doctor.  This is a third party that has nothing to gain from you having the surgery and I believe their words go a long way with n the insurance company over the words of the doctor who stands to make a few thousand dollars.  Another thought would be to look at a different weight loss doctor/surgery.  Someone else may have more experience with getting folks approved. 

Insurance companies only look at the short term.  So if you are not costing them anything now, by do they want to pay to prevent long term expense.  Chances are you will have a different insurance company then.  In my case, most of my health cost were drugs and having a different insurance company handle the drugs, I really thought it would be a fight.  But like I said, my Dr told me what to do, I did it and they tock care of the rest.   First attempt was approved. 

Good luck to you. 

Sounds like your surgeon prefers the RNY in which case find one who will support your wishes not his. Also lots of people just give up with the first denial and don't appeal so they never know if it would have been covered had they pushed harder, don't be that person. Another thing is that even if other people have the same insurance company they may not have the same coverage as you do, so the doctor's people don't know if it will be covered or not until they apply. Don't let them rain on your parade, go for it!

I'm going to go through with everything and if I get denied I will definitely appeal. There is another weight loss surgery office in town so maybe I'll look into them too just in case.