Jenrn903

Hi guys, I was banded as a self pay patient in 2007 and need a revision. My bmi is 41. I originally wanted DS but though this is an approved surgery, there are no in network providers who cover it. So from my insurance book I can see that I could definitely get approved for a sleeve but SIPS is not listed under covered procedure OR under excluded procedures. I was wondering if anyone had insurance that did approve a sips? I have UHC but any input is appreciated

I'd just double check with your insurance that they will in fact cover the single anastomosis procedure with a 300cm common channel. That procedure code is for the traditional switch and I have heard a couple of stories of people being approved under that code but then the insurance would not pay because it was actually the SIPS that was performed. I just don't want to see anyone left holding the bill on a 20k+ operation. Also, there is generally a second procedure code for band removal 43774 - Laproscopy, surgical, gastric restrictive procedure; removal of adjustable gastric restrictive device and subcutaneous port components.

Do you happen to know what CPT codes were used to get approval?

This is great news, do you happen to know what codes they used to get it approved?

I am looking to have band revision as well. I wanted traditional DS but there are no in network providers. Now looking at SIPS but I am not sure if insurance will cover it. Did insurance cover revision to SIPS for you? If not, how much did it cost?

Is this the DS surgeon in Cincinnati you were talking about?

Could you send me the info you sent her? I am in Cincinnati and trying to find a DS surgeon my insurance will cover as well