Vsg And Hiatal Hernia Repair - Cigna Insurance

[UTGal99 327]

I have a hiatal hernia and am looking to have a VSG done. My insurance is Cigna; however, I noticed that Cigna will not cover the hiatal hernia repair done in conjunction with the bariatric surgery.

Here is the statement from Cigna's coverage literature:

Cigna does not cover ANY of the following performed in conjunction with a bariatric surgery because each is considered not medically necessary• cholecystectomy in the absence of signs or symptoms of gallbladder disease

• liver biopsy in the absence of signs or symptoms of liver disease (e.g., elevated liver enzymes, enlarged liver)

• herniorrhaphy for an asymptomatic hiatal hernia

• routine vena cava filter placement for individuals not at high risk for venous thromboembolism (VTE)

I wonder if there is any way I can get my insurance to cover both procedures (VSG & Hiatal Hernia). If the doctor is going to be in there doing the VSG he might as well go ahead and fix the hernia, don't you think?

Any suggestions/tips/advice on how to get it covered in conjunction with the VSG?

Thanks!

[marie110 33]

[my insurance should cover hernia .. the hiatal hernia was discovered on the operating table and repaired i think you should just go ahead with sleeve and have the hernia repaired and work out the insurance later i don't see why they shouldn't cover if your doctor finds in medically necessary .. have your doctor write a letter to insurance... hope that helps...]

[traceyinflorida 499]

It says "asymptomatic" hiatial hernia. I guess that means that they cover hernias with symptoms.....where does it hurt? I bet you can get your doctor to write a letter of medical necessity.

[innerme 26]

I have Cigna and never was a issue with the hiatal repair coverage. I had already seen a dr and they had already advised to have surgery to repair. It was cheaper for the insurance this away anyway because it's one surgery instead of 2. My surgery was in June.

[O.T.R. sleever 3,386]

I think I'd talk to the Doc and see if he would be willing to fix and work out payment for that part. It really shouldn't be much. In Mexico the surgeons repair these as standard procedure with no extra charge.

[UTGal99 327]

Thank you for the feedback, guys. O.T.R.sleever, I would think they will just include it in the services too but just want to be sure.

[Ready4success 380]

I have a hiatal hernia and am looking to have a VSG done. My insurance is Cigna; however' date=' I noticed that Cigna will not cover the hiatal hernia repair done in conjunction with the bariatric surgery.

Here is the statement from Cigna's coverage literature:

Cigna does not cover ANY of the following performed in conjunction with a bariatric surgery because each is considered not medically necessary• cholecystectomy in the absence of signs or symptoms of gallbladder disease

• liver biopsy in the absence of signs or symptoms of liver disease (e.g., elevated liver enzymes, enlarged liver)

• herniorrhaphy for an asymptomatic hiatal hernia

• routine vena cava filter placement for individuals not at high risk for venous thromboembolism (VTE)

I wonder if there is any way I can get my insurance to cover both procedures (VSG & Hiatal Hernia). If the doctor is going to be in there doing the VSG he might as well go ahead and fix the hernia, don't you think?

Any suggestions/tips/advice on how to get it covered in conjunction with the VSG?

Thanks![/quote']

If you have GERD, that's symptomatic.

[IwantTHATshu 5]

I am so sorry to hear that! I was told I was dinied approvel for vsg and the hernia fix the day before my surgery! but after a lot of hard work I was able to figure out what I needed to do to get it approved and was lucky enough to have doctors that were wiling to help expidite the things I was missing.

It wasn't untill the day of surgery right before they were wheeling me to the OR did my doctor tell me that my insurance is crazy (cigna as well), but they werent going to approve the hiatal hernia...but He was nice enough to just repair it for us anyways for no cost.

I would talk to your doctor and see if there is a way he could write a letter of nessecity, also if you had an endosocopy by a seperate doctor maybe they could write something as well. It really is crazy not to cover it all togeather.

[ALIGAYLE 20]

Good to know-I need to check on this. I also have to have my hiatal hernia repaired during surgery. My surgeon told me personally that he checks every single patient for hernias during surgery . I also had 25 (now only 12 or 13) polyps from talking PPI's for years....all the rest of my polyps need to be removed before my VGS....

[UTGal99 327]

I also had 25 (now only 12 or 13) polyps from talking PPI's for years....all the rest of my polyps need to be removed before my VGS....

What are PPI's?

[ALIGAYLE 20]

Proton pump inhibitors-in my case Prevacid, Prilosec, etc.

[UTGal99 327]

I take Prilosec daily - they cause polyps? Hmmm, didn't know that. Should I be concerned and how would I know if I have a polyp? What are the symptoms?

[ALIGAYLE 20]

They CAN cause polyps and did in my case. No symptoms at all, just found out by doing the dreaded endoscopy...lol. I should tell you that I've had heartburn FOREVER, since my first pregnancy and she just turned 19. Lots of medicine for a looooonnnggg time.

[ShouldBlittler 89]

Benign polyps?

[ALIGAYLE 20]

I am assuming so-I haven't gotten the results back yet. Everything I've read says they are almost always benign.