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Insurance Troubles?

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If you are having trouble (as I did) with your insurer paying for

blood tests and things like a Dexascan, the following might help

you. Roux-en-Y gastric bypass patients carry a permanent DRG

(diagnosis related group) designation of " malnutrition,

postoperative " which is 579.3 (but have your Doctor'soffice check the

number, in case it has been change or I am misrembering it).

The " community standard of care " (which means the insurance company

has to pay for it) requires diagnostic procedures such as Dexascan

frequently (1 x a year) and a whole battery of blood tests several

times a year. If your Doc is not using that as a primary diagnosis,

you may have trouble with the approval from the insurance gnomes.

After my primary strting coding that my coverage problems went away.

Rick S.

Subtotal gastrectomy with open distal RNY bypass, 4/25/00

[Having twice the joy of life I ever thought possible after becoming

half the person I used to be.)

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