Question:
I JUST GOT APPROVED FOR ABDOMINOPLASTY BY BLUE
CROSS BLUE SHIELD/ FEDER AND HAVE TO HAVE IT IN 60 DAYS. I AM SCARED NOW!!!! I AM IN GOOD HEALTH AND HAVE LOST 120 LBS BUT I AM HAVING A DOUBLE HERNIA REPAIR TOO. ANYONE CAN YOU REASSURE ME THAT THIS IS BETTER THAN RNY WHICH I HAD TWICE????? THANKS FOR ANY HELP. — Mylou52 (posted on November 28, 2003)
November 28, 2003
Marilyn,
I had a panniculectomy and 9 hernias repaired. I know that's not the same
as an abdominoplasty as the muscles aren't involved except where the
surgical mesh is attached. I found it a bit more painful than the RNY but
I didn't find the RNY painful much at all. I only used my PCA one day with
the RNY. I used it three with the panni and hernia repair. But I went
back to work 2 weeks after both and believe me, the tt is worth the
discomfort. It doesn't last long and my hernias were so painful I was
thankful when it was fnally done.
— Patty_Butler
November 28, 2003
I had abdomnioplasty with 3 hernia repaired on November 17th. I will not
lie I hurt like an SOB for the first few days in hospital. But I am
feelling better everyday. I had Open DS and the pain was similiar. Go for
it girl you won it and deserve it!!!! http://www.geocities.com/stephileeaz
for my story
— Stephanie B.
November 28, 2003
I just had 3 incisional hernias repaired from my open RNY 1 1/2 years ago
and a lipectomy done as well (tummy tuck). This was done on 11/19/03.
Honestly, it was painful but not as bad as I thought it would be! The
hernia repairs hurt more than the tummy tuck. I ended up coming home with 4
drains from the tummy tuck but 2 were removed last week & the other 2
will be removed this coming Monday. I just had too much draining from one
side. As long as you go home & walk as much as you can it improves
everyday! I will be off work about 3 weeks. After losing 150 pounds, I
needed the tummy tuck & I am SO glad I did it! I still have pain (only
9 days postop) but it looks so great! I can't believe it! Do it! Especially
if your insurance approved it since it rarely gets approved! Good luck!
— Rosie B.
November 29, 2003
Hi Everybody! Thanks for your support! I have received a lot of e mails
asking HOW IN THE WORLD DID YOU GET BC/BS FEDERAL to approve? Just wanted
to give some info here to help anyone in the future. Caution: long.
First, the cpt codes for panniculectomy and abdominoplasty are one and the
same and the code is for an outpatient procedure. Believe it or not. I
think that is why a lot of people are in patient for 23 hrs and not 24 hrs.
So, with the Federal employees, the insurance company is instructed to
DENY right off any outpatient procedure because that is the way they were
instructed to do. I am having hernia repair at the same time which is
definitely inpatient. I had a difficult time convincing them this was
inpatient surgery. After they were convinced of this, they considered the
request. I had letters from my pcp, dermatologist, stating that I had
rashes. I wrote letters and used Sue Barr's letters adjusting them to my
own personal situation. Thanks SUE BARR! Her website is filled with help
and Teena Adler's as well. I sent the insurance company a total of 70
pages of documentation. I sent them my own pictures that I took of myself
too. Color. Because when the surgeon's secretary faxed the pictures he
took, they said they were not clear enough. I sent everything by certified
mail so that I could prove they received the package. My surgeon's
secretary did the same. Seems their favorite excuse is "we don't have
anything on you." If you think loose flesh is in your future after
WLS, start TODAY keeping documentation on rashes, prescripts, doctor's
visits, etc. I also have stress incontinence because of the weight of the
apron. I stated that. Low back pain is another medical reason for this
surgery. AFter sending all the documentation, the insurance made an
initial determination that it wasn't medically necessary UNLESS (read your
response from them carefully) I could send them 1. proof of my weight loss
with the starting weight stated on doctor's notes.
2. Proof of my loss as stated on latest doctor visit notes.
3. Proof that my weight had basically stabilized in the last six months.
After providing them this, I was approved. Oh Happy Day! The cost of the
panniculectomy/abdominoplasty was going to be $6,200 which was a bargain
because the anesthesia and operating room etc were going to be paid because
of the hernia repair. I think it is more if not included in that way.
Thanks for being there for me, guys. I am here for you as well.
— Mylou52
Click Here to Return