tamlalynn 13 Posted April 12, 2016 So, I was approved for the sleeve but denied for removal of the lapband because it is not medically necessary. I am confused. Has this happened to anyone? Sent from my SM-G900T using the BariatricPal App Share this post Link to post Share on other sites
silverthreads 183 Posted April 12, 2016 Appeal--that makes no sense! Sent from my iPhone using the BariatricPal App Share this post Link to post Share on other sites
tiffanymarie6997 115 Posted April 12, 2016 So, I was approved for the sleeve but denied for removal of the lapband because it is not medically necessary. I am confused. Has this happened to anyone? Sent from my SM-G900T using the BariatricPal App I was approved for the sleeve but denied for my hiatal hernia to be fixed. My doctor said he will be repairing it anyways as it is necessary for my sleeve to be as successful as possible. If the lap band will interfere with your sleeve success, hopefully your doctor has the same mindset as mine. I would definitely ask your surgeon about it. Sent from my LGLS990 using the BariatricPal App Share this post Link to post Share on other sites
waterwoman 181 Posted April 12, 2016 My experience was similar - I was approved for the bypass, but denied for the band removal. My surgeon's office called the insurance company, submitted the paperwork a second time and I was approved. Keep at it! Best of luck to you. Share this post Link to post Share on other sites
itsforever 2 Posted April 12, 2016 I don't know if my removal would have been denied, but because I had really bad acid reflux I assume that is why it was covered. Do you have any complications with it? Sent from my iPod touch using the BariatricPal App I don't know if my removal would have been denied, but because I had really bad acid reflux I assume that is why it was covered. Do you have any complications with it? Sent from my iPod touch using the BariatricPal App Share this post Link to post Share on other sites
tamlalynn 13 Posted April 13, 2016 I am actually approved. The notice was indicating that the Surgeon would not be paid for 2 procedures. They just had to change some codes. Officially approved! Sent from my SM-G900T using the BariatricPal App Share this post Link to post Share on other sites
Mburk72 13 Posted April 20, 2016 So, I was approved for the sleeve but denied for removal of the lapband because it is not medically necessary. I am confused. Has this happened to anyone? Sent from my SM-G900T using the BariatricPal App The sleeve is the more expensive procedure, so most doctors will go ahead and take out the band if that's what u want, during the time of the sleeve. I work in the OR, the removal of the band doesn't require anything extra that isn't already there for the sleeve. Sent from my XT1254 using the BariatricPal App Share this post Link to post Share on other sites
