pre-op testing - liver biopsy??? - ThinnerTimes - Gastric Bypass Forum, Lap Band Forum, and Vertical Sleeve Gastrectomy Forum

racha9 · 05-08-2008, 07:58 AM

My mom is currently going through her 6 month program; May is her third month, and will be meeting with the surgeon after that for her first eval with her.

She was reading in her insurance booklet, and it states that a liver biopsy is required as a pre-op test, along with the normal psych eval, 6mos diet and exercise, etc. Has anyone ever been required this??? They say that it is to determine fatty liver disease. Could they not do an ultrasound? That is what I had done, and they were able to see that my liver was fatty. This just seems like a very invasive, and unecessary test, when there is (I think)an alternate and less invasive way.

Do you think that the surgeon could dispute this if it is indeed required?

RebeccaNV · 05-08-2008, 08:37 AM

Wow, that is really interesting. Who is her insurance provider?

I haven't had GBS but I am considering it due to having diabetes and having been diagnosed with a fatty liver back in Feb. This was diagnosed via ultrasound and increased liver enzymes. I had a liver transplant (in Pittsburgh at Presby) and am now followed by the VA. No one at my local VA suggested a biopsy to confirm diagnosis of the NAFLD (Non Alcoholic Fatty Liver Disease) but I think that if I were to go to a transplant or a liver clinic (would have to travel to San Fran for this) they would prolly want to do a stab and jab. I personally don't feel that this is necessary for diagnosis.

How are your mom's liver enzymes? Is she diabetic?

racha9 · 05-08-2008, 08:43 AM

Quote:

Originally Posted by RebeccaNV

Wow, that is really interesting. Who is her insurance provider?

I haven't had GBS but I am considering it due to having diabetes and having been diagnosed with a fatty liver back in Feb. This was diagnosed via ultrasound and increased liver enzymes. I had a liver transplant (in Pittsburgh at Presby) and am now followed by the VA. No one at my local VA suggested a biopsy to confirm diagnosis of the NAFLD (Non Alcoholic Fatty Liver Disease) but I think that if I were to go to a transplant or a liver clinic (would have to travel to San Fran for this) they would prolly want to do a stab and jab. I personally don't feel that this is necessary for diagnosis.

How are your mom's liver enzymes? Is she diabetic?

She is newly diagnosed type 2 diabetes. I am not aware of any LFT's. They may have been done, but were not shared with her.

Her insurance is Highmark BC/BS PPO

Amandazon247 · 05-08-2008, 08:49 AM

HMmm well they did a a liver biopsy on me during my RNY because Dr. Dyer saw a spot he didnt like... and I am a cancer survivor. But all came out well... I cant imagine they would want 2 surgeries. They may take during the RNY or lap band surgery.

RebeccaNV · 05-08-2008, 08:52 AM

Quote:

Originally Posted by racha9

She is newly diagnosed type 2 diabetes. I am not aware of any LFT's. They may have been done, but were not shared with her.

Her insurance is Highmark BC/BS PPO

I recently read a stat where 83% of type II's have fatty liver disease.

How old is the insurance booklet? Maybe they have changed this practice? Perhaps they will accept an ultrasound scan in place of a biopsy?

RebeccaNV · 05-08-2008, 08:53 AM

Quote:

Originally Posted by Amandazon247

HMmm well they did a a liver biopsy on me during my RNY because Dr. Dyer saw a spot he didnt like... and I am a cancer survivor. But all came out well... I cant imagine they would want 2 surgeries. They may take during the RNY or lap band surgery.

What did the biopsy show and if you don't mind, where was your cancer?

Grammy O · 05-08-2008, 11:53 AM

I have Wellmark BCBS and there is nothing regarding a liver biopsy requirement.

HMMMMM

KittyKay · 06-22-2008, 01:18 AM

I am the liver queen! It was discoved my liver number were 5x what they should be about a year ago. I went threw many tests such as pee test, bloodtests ect. The conclusion from m y liver specialist was that I have fatty liver but he couldnt be 100% certain unless I got a biopsy. I did the biopsy and it showed Fatty Liver stage 2. This helped to show how bad I need wls. Any other questions hit me up.

Withacy · 06-22-2008, 08:08 AM

I worked in the health insurance field for about 15 years before coming to the federal government 10 years ago where I'm one of the people overseeing the Medicaid program. I've read a lot of policy & proceedures in my time, and more State (Medicaid) Plans than I care to. It's possible they DID mean you absolutely have to do these six/seven/whatever things - PERIOD. Or they could mean its something she might have to do based on medical necessity. It just seems awful invasive to me, unless they have a very narrow range of things that wls is approved for - and fatty liver is one of them.

Another thing is, it's awful expensive for the insurance company to pay for. And to be perfectly cynical, if it's not going to have an important baring on the decision, I can't see them paying for it so routinely.

I'd definitely call the insurance company and get clarification.

offstringgirl · 07-02-2008, 10:22 PM

My liver biopsy will be done during my RNY.