Lindypie

Hi again, Chocolate snaps..in California, we have insurance codes..Look up New York Health and safety codes online to see what you have under the heading of reconstructive surgery. Also check to see what your state insurance codes says about coverage for these surgeries as well. If you have a chance go online and type in cpt and icd codes and their definitions..these are universal codes. Go on the web under WLS and find some examples of letters of denial if you are denied coverage. These may be a guide to help you with examples that pertain to you, for you to write a letter of appeals. Hope this helps! Keep in touch Linda

Hi Chocolate Snaps, Love your name....I actually went in for a follow up for something else. I also told him about my recurring headache, neck and lower back pain. When he tapped my neck and back he said that I was wincing. He gave me a referral to a PS. The surgeon took lots of photos and measurements of my breasts and also of my tummy. I was approved in just 10 days! He and I were shocked that they would cover all. So please document all with photos and also in your case I would call and/or see your primary DR with complaints of your pains and of rashes under your skin...including your breasts...also get prescriptions for anti-fungals. I hope for your success! Linda

Hello everyone, Haven't checked in for a while. Just wanted to say to please document everything...don't be shy to communicate with your primary physcian. I am two years out highest weight 231lbs. down to 165lbs. I have been at this weight for about a year and a half. last May of this year 2009. I had a breast reduction with lift and a tummy tuck. YES my insurance company [Health hmo] covered ALL of it. No out of pocket fees. I DOCUMENTED EVERYTHING rashes blisters etc. I had my doctor document everything in person and arranged to phone in to his nurse anything related to my discomfort and put it in my file. Although you may think as I do that I have not lost as much as I wanted too,My dr. said that everyoe settles sometimes at the weight our bodies are set at. Do not give up...Please research on the web about how to appeal if you get denied. Happily I did not have to but I was ready for rumbling with my insurance co. if I had to. Please be your own advocate,You have not worked this hard only to be half done with your accomplishments! Good luck to you all and fight to be healthy!

Hi, thank you, I am really nervous about the surgery, but I hope it will relieve me from my migraines,back and neck pains! You may think that you are slow in losing weight but you are already a success! You have been brave enough to do something about changing your health and prolong your life! Slow and steady wins the race! Good luck to you and all the rest of us! Linda

Hi, I just posted on another thread. Yes, my TT and breast reduction w/lift has been approved by my insurance company. My plastic surgeon and office personnel are just as surprised as I am! I am scheduled for April 2009.

Hi Patsy, and everyone, I haven't posted for a while. I am also at a plateau. I was banded on Sept 18 2007. I have lost about 60lbs. I have been at this weight for 7 months! I was also begining to droop in my tummy and breasts,etc. for the last 7 months also. The silver lining is that my pcp,thinks that maybe this is where my body has settled to be. Because of the pain and migraines I have been enduring, my doctor sent me to a plastic surgeon. As to my surprise, my plastic surgeon submitted paperwork for a TT and Breast reduction. I was approved! One of the criteria was that my weight has been stable for at least 6 mths. Although I would have liked to have lost more , The pre-banded symptoms have been eliminated. I am grateful! I hope that anyone out there who is going through plateaus... give yourselves a well deserved break. There is always a reason for everything. Keep positive! Keep having faith. Maybe we have to accept what our bodies are telling us. Good luck to us all! Linda

hello everyone, I was just wondering if anyone with hmo healthnet has had approval for a panniculectomy? thank you! Linda

Hi, Just checking in..I have lost 55lbs since my highest weight. Everyone seems to be doing great!

Hi, well, I been complying, with the rules! My problem now is that I have had a migraine headache the day after my last appointment. It lasted 3 days! around 8-9 o'clock I also get tummy aches!...but I am doing the baby spoonfuls that my dr. demands. This can't be good. I do not think that my eating 1/2c. per meal puts me in the hog section! I thought the fills for my lapband would not be so hard to get! I forgot to mention that my surgeon said, at last weigh -in, that he is glad that I had not gained more than 1 pound, because he would have me go see a shrink!

Hi Joe, How much are you eating per meal...I am only supposed to have 5-8 baby spoons per meal plus two shakes a day. I usually have -1/3c to 1/2c per meal. I also don't need my cpap. I exercise 3-6 days a week..and am still recovering from a brokrn L ankle

Hi, I DON'T KNOW WHY HE IS SO TIGHT WITH FILLS! It drives me nuts he says that I am having head hunger! 2cc.in a 10cc band after 7 months does not seem alot to me either. He does not have an associate to do the fills. He also talks so fast that he barely lets me ask any questions! I thought that the patient would know when it time for a fill. I have been working really hard! My first fill was at 5 mths out! So I know how to eat! I am so sad and disappointed! I am constantly made to feel like I am an annoyance to my dr. Thanks for your response! Linda

You two look fabulous! you are both sooooooooo pretty! Keep up the good job!

Hi everyone, Haven't checked in for awhile. I went in today...gained one pound ! My surgeon says no fill for me today! Last month he was in a bad mood and scolded me for coming in two weeks before I was due to come in. But his nurse asked him..and said That I probably needed a fill. This month I was under a lot of stress :wink2: and did not do as well as I should. I feel so discouraged....I am down 47lbs since being banded on Sept 18 2007. Has anyone had a slip? I am so scared !!!!!!!!!!! I don't want to gain any weight. He still only wants me to have around 5-6 baby spoons of food per meal. I sometimes have a 1/2 c per meal. He scolded me and said he would not give me a fill today...I have had 3 fills totaling 2cc. in a 10cc. band. That does not sound like it is enough. Please share your story with me. I need your support! Thank you for letting me vent! Love to you all, Linda