Is a 3 month or 6 month supervised diet required for a revision?

mrlddst · March 26, 2010

I was talking to the practice manager where I plan on having my revision done if/when Aetna decides to cover the VSG. I was approved for a revision back in Nov'09 to replace my band, they were not able to and could only remove the band, my port is still in place. She said that I may have to do a supervised diet to get approved for another revision. That really confuses me because it would seem as if I should already be covered by the Nov'09 approval. Anybody else have to jump through any special hoops?

I think I'm going to make an appt for my PCP just to get my weight logged for the month.

Morgandobes · April 18, 2010

Hi

I see that no one answered your post, so I will give you my experience.

I originally had a lap-band in 2005. I did not need to do the supervised

diet thing, just write a history of my issues with weight loss and re-gain.

(I think my insurance was either aetna or united health care)

I am now getting the band removed. My current insurnace provider, anthem blue cross blue shield, just says that I need to show "medical Necessity". Nothing said about a supervised diet.

Hope you are getting the answers you need,

Lisa

Jackie100 · April 27, 2010

Aetna is now covering Sleeve surgery. Have you gone back to them? I consulted 2 weeks ago with my Dr. Want band removed and revised to sleeve. They told me Aetna just started covering it. I am waiting for approval but they want me to see a nutritionist at least 3 times before they put the request through. Having had an unsuccessful band should be pre-approval enough, I think!

mrlddst · April 27, 2010

Well I did go back to my surgeon and they are going to submit a letter of pre-determination this week. In the mean time, I have been told to also act as if I am trying to get approval again, so I need to see my nutritionist and PCP 3 times over the next four months.