Guest guest Posted May 9, 2001 Report Share Posted May 9, 2001 I got my denial letter from AETNA today, denying my BPD/DS. However I know there are numerous of you out there who have been approved by AETNA for this surgery. Does anyone know what code your surgeon used to submit for precertification? Was anyone approved without an appeal? My appeal will be send out tomorrow. Any help will be greatly appreciated. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 9, 2001 Report Share Posted May 9, 2001 Hi: I've gone through 3 denials with Aetna and they don't want to hear from me again. What I have found to be the case is that once you have been denied it will continue. I had asked for the help of Walter Lindstrom at Obesity Law Advocacy, but got roped into believing I could hire him after my final denial. Unfortunately, I could have, but it would have been for much more money than if I hired him during my appeal process. If you are able, I highly recommend hiring Walter and his wife, . They are wonderful people who have had success with Aetna in the past. Unfortunately for us, Aetna is a tough one to crack. Many people have, such as Murdock, who is set for surgery in the morning, but many of us have not. I don't mean to be a downer because I firmly believe I will have the surgery one day, but something (namely Aetna) is saying now is not the time. Good luck to you. proud sister of Vicki in Sac who has lost 135 pounds since 9/20/00 pre-op myself: Dr. Rabkin > I got my denial letter from AETNA today, denying my BPD/DS. However > I know there are numerous of you out there who have been approved by > AETNA for this surgery. Does anyone know what code your surgeon used > to submit for precertification? Was anyone approved without an > appeal? My appeal will be send out tomorrow. Any help will be > greatly appreciated. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 10, 2001 Report Share Posted May 10, 2001 Hi, The usual and customary codes used for our procedures are as follows 43847- gastric bypass w/ small bowel reconsruction to limit absorption 43633- Subtotal gastric reduction 47600- Cholesectomy(sp) Gallbladder removal The last code I'm not POSITIVE about because I didn't have my gallbladder removed. Good Luck! -- In duodenalswitch@y..., choneycutt@k... wrote: > I got my denial letter from AETNA today, denying my BPD/DS. However > I know there are numerous of you out there who have been approved by > AETNA for this surgery. Does anyone know what code your surgeon used > to submit for precertification? Was anyone approved without an > appeal? My appeal will be send out tomorrow. Any help will be > greatly appreciated. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 10, 2001 Report Share Posted May 10, 2001 Hi, The usual and customary codes used for our procedures are as follows 43847- gastric bypass w/ small bowel reconsruction to limit absorption 43633- Subtotal gastric reduction 47600- Cholesectomy(sp) Gallbladder removal The last code I'm not POSITIVE about because I didn't have my gallbladder removed. Good Luck! -- In duodenalswitch@y..., choneycutt@k... wrote: > I got my denial letter from AETNA today, denying my BPD/DS. However > I know there are numerous of you out there who have been approved by > AETNA for this surgery. Does anyone know what code your surgeon used > to submit for precertification? Was anyone approved without an > appeal? My appeal will be send out tomorrow. Any help will be > greatly appreciated. Quote Link to comment Share on other sites More sharing options...
Recommended Posts
Join the conversation
You are posting as a guest. If you have an account, sign in now to post with your account.
Note: Your post will require moderator approval before it will be visible.