Scooterbug

I have to agree with all the other posts....it actually takes some time to start losing....I only wish it started melting off from day 1. I personally did not see any weight loss more then a few pounds for almost a month and 1/2. After I finally did start losing I was plateauing every 5 or 6 pounds (sometimes would take a few week to a month to lose again)..even to this day I keep plateauing every few pounds. Last week I got a fill and lost 6 pounds right off the bat....now have stayed the same weight for the last 5 days..not even a lose of a few ounces since then. It can be frustrating at times....but don't give up.

As a medical coder I can tell you for sure that it is NOT because of a code. There is only 1 code for insertion of a Lapband device...and all Lapband surgeons offices use that same code anywhere in the US. So if there is an exclusion it is because the OP's employer chooses not to include the Lapband in there plans. Furthermore asking the hospital to change a code so you can get a procedure approved, or a hospital/doctor's office changing a code for you to get a procedure approved is considered fraud...which could carry a HUGE monetary fine and/or time in jail...just FYI.

I heard Dr Baptista is waiving transfer fees for anyone interested in going to him. He is an awesome Doctor. I was initially a patient of Dr Cywes from Jan 2012 - August 2012. After alot of frustrating dealings with his staff (not filing my claim on time, phone calls never returned,miisinformation, etc), my wife and I switched to Dr Baptista. It was the best decision we ever made!!

Sorry to hear you are having so much trouble getting a hold of someone at Dr. B's. Not sure if they are having staffing issues at the moment or not. I do know they work 1/2 days on Fridays. Do you have the direct number for Rosie? If you still can't get a hold of her I can shoot you her email address.

After my surgery I was having a lot of pain at my port site....It got so bad the pain meds would not even help it. I called Dr. B's personal cell phone number to talk to him for advise. It was way after office hours..and he actually met me and my wife at the office. He discovered I had a pinched nerve near the port site (which he said happened to like 1 in 300 people or something like that..real rare). Needless to say he got me taken care of....made sure there was nothing wrong with the band, wrote me a new script, and I had no problems ever since!! Wish my PCP was as nice as Dr. B.

First thing to do is not panic. Second, if you got your EOB (explanation of benefits) or are able to access them online, you should be able to see all charges listed for your surgery. Next to each charge you SHOULD see a 5 digit code. These are called CPT codes and this is how coders bill for procedures/surgeries. You will want to try and locate your Gastric Band CPT code..which should be 43770. When an assistant surgeon is used a "modifier" is added to that code in the form of modifier 80. So IF coded properly the Gastric band code should be 43770-80 (Gastric band procedure with the help of an assistant surgeon). Make sure there are no other codes that have the modifier 80 next to them. Coders do sometimes make mistakes and you want to make sure modifier 80 is not added to a code that insurance would not think would require an assistant surgeon to help with. So for instance... hypothetically..lets say a coding mistake was made, and modifier 80 was added to the code for placing an IV. The insurance company would say "Why would it take a primary surgeon and his assistant to insert an IV?" That would be denied right away by insurance. SO.... my suggestion is look over the codes, if it's not too confusing, and make sure everything looks right OR call the insurance company and ask why they denied the charges for the Assistant Surgeon. If it was a coding mistake it should be easily fixed by your surgeons office and resubmitted.

I couldn't agree more..Dr Baptista is awesome!!!

My wife and I have a UHC Options PPO. they also said they required a 5 year weight history. I was missing 2010 and my wife was missing 2009, due to the fact that we only went to the doctor when we were REALLY sick..meaning we didn't get sick enough to go to a doc those years. We were approved in less then a week even with those missing..so you might be ok missing 1 year

Just a small update (it's been awhile since I last posted)... First i want to thank everyone who suggested Dr. Baptista..he is really awesome!! I only wish I had a PCP as nice as him Things were a bit rough starting off. Right after surgery I was feeling extraordinary. My wife on the other hand was very nauseated after surgery. On the way home my Father (who drove us to and from the hospital) hit a pothole in the road and that was pretty much the end of my feeling good. As the days went on I kept getting a stabbing pain near my port site, that the pain meds would not even dull. About a week after the surgery it became so unbearable that I almost went to the ER. My wife called Dr. Baptista's cell phone and he actually met us at his office (this was 7:30pm, I don't know any other doctor that would do this). Apparently I had a pinched nerve near my port. Dr. B fixed me up with some muscle relaxers which helped a good bit. After I was able to get the pain managed my wife and I became frustrated because the scale was not moving..as a matter of fact it seemed to go up . We talked to the staff at Dr. B's office and they keep saying the same thing about "eat as much Protein as you want and stay under 30 carbs". The dietitian/nutritionist at there office said the same things..yet the scale would not move. We were both at the point of almost giving up because we could not figure out why we were not losing. In mid September my wife started taking a tax class. One of the woman in her class was actually a licensed nutritionist, so my wife explained our situation. The woman said a common thing people hear the terms "stay under 30 carbs" and they actually do no carbs or very very little. She explained that you still need some carbs to help process the protein, plus she said to up vegetable intake. Not sure why Dr. B's nutritionist didn't say that, but we figured we would give it a try. After making these few tweaks we actually started seeing the scale go down for the first time since our surgery date! Since we made these changes I have lost 21 pounds and my wife has lost 15, In total since we started our Lapband journey (our 6 month PSD) I am down 60 pounds and my wife is down 37 pounds. Physically I did not see it..because i am used to seeing myself so big. This past weekend my wife decided we were going to clean out our closet. She made my try on clothes, and we were donating anything that didn't fit to Goodwill. She pulled out some dress shirts that back in February I could not even hope to get buttoned up. I was in utter shock when I put them on and not only COULD I button them, but they were so big I was "swimming" in them!! That was the first time I could actually feel that I had lost weight. The scale said i had..but now I can "feel" it!!! My wife tried on a pair of shorts she was given about 7 years ago...back then she could not get them buttoned and she said they were so tight she though they would rip. Now they fit..and they are loose on her..she said they were so comfortable now, and she ended up wearing them for the rest of the day So needless to say..after a slow start..we are both now making headway!!

The nutritionist I was dealing with was at a different practice then the doc who actually did my surgery. I saw that nutritionist for the 6 month supervised weight loss. At that time I was given a list of foods, and told "Keep carbs to 30 grams or less a day, and don't worry about calories". I did this for several months and lost maybe 1 or 2 pounds a month. The nutritionist said I should be dropping weight like crazy. I told her the only times in my life I actually lost weight was when I did EXTREME calorie counting, 600 calories or less a day. She told me to go with what works. So I did..and that when I started losing. Even after losing almost 30 pounds..the doctor at that practice still accused me of eating "cake and ice cream"....If I was I certainly wouldn't have lost almost 30 pounds. Due to one physician quitting the practice, another not being able to operate at any hospital in town, and a complete breakdown by there office staff...I went to another doctor and he was the one who did my surgery. I lost another 9 pounds on the Pre-Op diet, which brought my total Pre-Op loss to 39 pounds. I will find out if my newer doc has a nutritionist to work with.

Instructions were basically to not worry about calories...just to 75 to 80 grams of protein a day, and less then 30 carbs. Plus we were given a sheet with what we could eat certain amount of days after..such as 1 to 7 days after, 8 to 12 days after, etc, etc.

Exercise at the moment is a bit tough...to elaborate... After surgery I had a good bit of pain near my port area. I figured this is normal and it would go away in time. My doc had me on the standard liquid hydrocodone for pain. I soon found out that the hydrocodone would not even come close to helping the pain. A week after surgery the pain got worse..and one day it got to an almost unbearable level. I saw my doctor again that day and he checked and made sure everything was ok with the band. He did say that the port is pinching a nerve, which is making all the muscles in that area spasm. he gave me Tramadol to relax the muscles (makes me sleepy too). Even though the Tramadol eases the pain..I can still feel it there when I walk, sit, or sleep. My doc said the next step is for him to do an injection that will deaden the nerve so the pain will stop. So basically, at the moment, walking for then 10 feet agitates the nerve and causes pain. I think I may call the doc tomorrow and tell him I need the injection.

Not too tight to eat yet, haven't had a fill yet. Pre-op I was doing 600 calories or less...consisted of no Breakfast or lunch....a diet soda during the day..and some chicken or fish for dinner..thats it.