Question:
Has any of you been approved for lapband but the letter said RNY?

Paperwork was submitted for the lapband, when I called they said it was approved but when I got the letter it said RNY? just wondering if this has happened to anyone else    — Michele T. (posted on April 25, 2004)

April 25, 2004
While Aetna has started covering the Lap Band, there are special criteria (from http://www.aetna.com/cpb/data/CPBA0157.html): <p> <b>Vertical Banded Gastroplasty (VBG) and Laparoscopic Adjustable Silicone Gastric Banding (LASGB or Lap-Band): </b><br> Aetna considers open or laparoscopic vertical banded gastroplasty (VBG) or laparoscopic adjustable silicone gastric banding (LASGB, Lap-Band) medically necessary for members who meet the selection criteria for obesity surgery and who are at increased risk of adverse consequences of a RYGB due to the presence of any of the following comorbid medical conditions: <p> <li>Hepatic cirrhosis with elevated liver function tests; or <li>Inflammatory bowel disease (Crohn's disease or ulcerative colitis); or <li>Radiation enteritis; or <li>Demonstrated complications from extensive adhesions involving the intestines from prior major abdominal surgery, multiple minor surgeries, or major trauma; or <li>Poorly controlled systemic disease (American Society of Anesthesiology (ASA) Class IV). <br> If you do not have meet these criteria, I would question whether you are truly approved for the lap band. You may want to check with the surgeon's office to make sure that is what they filed for...JR
   — John Rushton

April 26, 2004
Definitely need to get this clarified in writing. I was surprised when my approval came through and said that a VBG and standard RNY were approved but that a mini RNY or long limb RNY were not. My surgeon had submitted for an RNY so there wasn't much of a problem, other than the word standard, but I still was surprised of their restrictions.
   — zoedogcbr