Part 2 Re: Medicare policy

[Guest guest]

F,

The intestnal bypass surgery they are refering to was pre-Scopinaro.

It was called the jejnel-illal bypass (JIB) and involved bypassing

more than 90% of the intestine and leaving the rest as a blind loop.

The malabsorption was extreame and not selective. JIB was one of the

first weight loss surgeries developed and it was popular in the

1960's. It has since fallen into disripute and was subsequently

replaced by the restrictive procedures. Unfortunately, the legacy of

JIB is a continued prejudice in the medical field against ANY

malabsorptive procedure including BPD and BPD/DS.

Hull

> > That was incredibly depressing Pam...................Elle

>

> First they say the following:

>

> " The safety of intestinal bypass surgery for treatment of obesity

has

> not been demonstrated. Severe adverse reactions such as

steatorrhea,

> electrolyte depletion, liver failure, arthralgia, hypoplasia of

bone

> marrow, and avitaminosis have sometimes occurred as a result of

this

> procedure. It does not meet the reasonable and necessary provisions

> of §1862(a)(1) of the Act and is not a covered Medicare procedure. "

>

> It's quite clear they are referring to the old Sopiunaro with the

> 50cm CC, which of course has been corrected, because

>

> 43847 with small bowel reconstruction to limit absorption

>

> IS covered!

>

> It's all clear to me now just why our surgeons must code correctly.

> Those who are reluctant must somehow be convinced to play the game!

>

> I may be too optimistic in my interpretation of all this, but it

> seems like you could make a good case in your appeal. I have more

> info to post but have to go towork now, so, later gang!

>

> F.