Just found out that I was denied revision due to GERD, the day before pre surgical testing tomorrow!

I'm sooooo angry!! 6 weeks, I've waited and this is what they do!!?

I'm so sorry about this. Can it be appealed?

I hope so, on hold with insurance now.... pathetic, its gastro related due to sleeve and they want more clinical visits and a nutritionist again.... I think someone dropped the ball on this one

Insurance was a major hurdle when I had my sleeve, but it was approved very quickly when I needed a revision due to GERD. I had already had a motility study, a pH study, and endoscopy done by the time I applied though.

me too - had gastro endo another swallowing test, etc... they're ridiculous - they are also stating I didn't maintain loss for 2 years.... they are missing the point

It sounds like someone in the surgeons office coded things wrong, and they are evaluating it as a weight loss revision rather than as complication revision

Maybe you’re right.
I called my gastro and they told me diagnosis from endo is GERD.

I had them fax results to doc again.
They stated denial is I didn’t have psych and 6m of visits for the last 2 years. Which is what I did last time. And still high BMI.

This should be different I was told. so I’m sure you’re right. They aren’t coding it correctly or someone at the insurance company isn’t doing their job.

They used 43644 as cpt code

Yay!!

overturned today. I’m moving forward