Revisioners, I need input...

[Wheetsin 714]

So out of the blue today I got a call from my surgeon's office (this is after 9 weeks of nothing) that my band (slipped) removal has been approved, when did I want to schedule it for. Can I add something really strange? After all these weeks of waiting, I had a dream lastnight that I was in surgery for removal. Odd!

So I told the nurse who called that I had "applied" for a revision, not just removal (I know they're separate procedures in terms of billing & insurance, but my surgeon's office - in terms of procedure and paperwork - treats revisions as a single case)... and asked if they had submitted for approval on just the revision or on both. She said only removal.

Now, when my slip was first diagnosed I was told I was NOT a candidate for re-banding or repositioning, and that my slip was too "profound" to reposition it with any surety of it not slipping again. When my EGD was done the surgeon told me it needed to come out, and he did not want to try to just reposition it. So it was a total shock to me that she was talking about him trying to reposition it... and my wits weren't with me and I didn't respond accurately. I've since tried to call back but she was out so I left a message. This nurse told me, "Well he'll go in there and look around, and try to reposition it if he can."

I was really caught off-guard by that, and completely caught off-guard by her call in the first place, so I didn't respond the way I should have. I said something like, "Well <PA> and <surgeon> both indicated that would not be an option for me, so understandably I'm hesitant to sign up for removal when I don't know anything about approval for replacement."

I also clarified in my message to her that that both the NP and surgeon had said I would not be a candidate for repositioning or rebanding.

So - I need some inputs.

This has been in play since early June. Since then, I've pretty much, in my mind, committed to losing my band and getting a sleeve revision. I'm disappointed that they want to try and reposition the band. I'm disappointed that I specifically go through the legwork (it was not a cake walk) of doing all their paperwork and requirements for a revision and am now being contacted about a "reposition of we can, removal if we cannot" appointment. I don't want it to be repositioned, I want it out. I have 0... in fact, if possible, I have negative confidence in ANY sort of longevity with a repositioned band.

I wanted them to, and completely thought it's what they were doing, submit for REMOVAL and REVISION.

Did they jack something up? Do you have to be medically ineligible, as proven by surgical examination, to have a revision? WTF would they even have me slated as a "potential reposition"?

I'm split between continuously trying to reach this lady/nurse, and just driving down there. I'm borderline pissed off because 9 weeks is a long timeto wait and then find out that what they seem to have been working on isn't what I applied for/wanted.

Revisioners who DID NOT go through an attempt at repositioning the band, what was your experience? Did you get both approvals at once? Was something special required to bypass the reposition attempt?

THis is a total wrench being thrown in and I am NOT a happy camper. But I don't want to be ticked if it's the way it is...

[KristeyK 3]

Maybe the person you spoke to misspoke, or heard it wrong. Revision/reposition...they COULD be confused. (Trying to keep my hopes up for you!)

[CowgirlJane 14,261]

Sounds very strange, and it does make you wonder if the person was confused.

I have not yet had the removal, but my approval is for two separate procedures - removal and then secondarily a sleeve. I am pretty sure that the "repositioning" is a different CPT code.

[kekerene 35]

I went to Mexico to Dr. Aceves. Unfortunately my insurance did not cover any type of weight loss related procedures. Also, my surgeon here had little to no experience with the band to sleeve revision. This is why I chose Dr. Aceves. I am sorry that you are having to jump through hoops with this, all the while having to live with a slipped band. Mine slipped too. I am sort of glad it did because I lived 5 miserable years with that thing. My life and health have changed so much in just the past 2 1/2 months since I had my revision. The sleeve is everything that the band was promised to be without all the issues/complications that the band brings. I really hope you can get your revision and this can get resolved for you quickly, good luck!

[kipepeo 0]

my band was removed and converted to sleeve in same surgery. Could you call your insurance company to understand exactly what was requested by the doc and what they approved? I was never shy to call the insurance company and inquire - after all, its our life!!

[Tippy2us 11]

My doc got approval for removal and revision all in one procedure.

Best of luck to you.

[Wheetsin 714]

Oh I may have miscommunicated something. It wasn't an insurance denial -- my surgeon will not do a revision in a single surgery. And frankly, I prefer it that way. The confusion was at the office, but what was presented to me was that it was a "medical standard" to always try and fix the band before removing it. That was confusing to me because I knew it wasn't the case. I didn't do a great job of follow-up to this post, though -- I called them back as soon as I had my wits about me and made it very, very clear that I was not interested in the surgeon trying to reposition the band, or being re-banded. That took care of it, and their response was, "Oh ok, then we'll just mark you down for removal."

I guess the majority of their slips want to try and keep their bands. I have NO doubt that if it slipped, it would just slip again, so why waste the surgery?

Band came out yesterday.

Now I need to stay on their asses to get my sleeve pre-approval submitted. That's going to be the weak point (the people who do the letters)