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05-08-2008, 07:58 AM
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#1 (permalink)
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Member
Join Date: Jan 2007 |
Location: Pittsburgh |
Surgeon: Dr. Raftopoulos |
Age: 36 |
Posts: 174 |
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pre-op testing - liver biopsy???
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?
__________________
Rachael
Lap RNY 6/6/07
Dr. Raftopoulos - Pittsburgh
Highest/Current/Goal
248/138/118 - updated 4/28/08
"Nothing great is ever acheived without much enduring" - St. Catherine of Sienna
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05-08-2008, 08:37 AM
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#2 (permalink)
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Senior Member
Join Date: Mar 2008 |
Location: Northern Nevada |
Surgeon: Dr. Kent Sasse |
Start Weight: 221 |
Current Weight: 190 |
Goal Weight: 120 |
Age: 45 |
Posts: 1,109 |
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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?
__________________
Liver Transplant Survivor 24+ yrs
Proud Disabled Army Vet and Army Mom - Go Bubba!
Everything that you want is downstream
08/09 Denied by Tricare and not sure what I will do next.
Last edited by RebeccaNV; 05-08-2008 at 08:40 AM..
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05-08-2008, 08:43 AM
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#3 (permalink)
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Member
Join Date: Jan 2007 |
Location: Pittsburgh |
Surgeon: Dr. Raftopoulos |
Age: 36 |
Posts: 174 |
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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?
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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
__________________
Rachael
Lap RNY 6/6/07
Dr. Raftopoulos - Pittsburgh
Highest/Current/Goal
248/138/118 - updated 4/28/08
"Nothing great is ever acheived without much enduring" - St. Catherine of Sienna
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05-08-2008, 08:49 AM
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#4 (permalink)
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Senior Member
Join Date: Feb 2008 |
Location: Nashville Tn |
Surgeon: Dr. David Dyer |
Start Weight: 301 |
Current Weight: 164 |
Goal Weight: 170 |
Surgery Date: 03/31/2008 |
Age: 35 |
Posts: 914 |
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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.
__________________
Century Club 11/2/2008
Onderland 11/3/2008
You can think of a million reasons to hate yourself today.... or you can be original and focus on one reason to love yourself. (manda2008)
N O T O R I O U S MANDABEAR!!
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05-08-2008, 08:52 AM
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#5 (permalink)
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Senior Member
Join Date: Mar 2008 |
Location: Northern Nevada |
Surgeon: Dr. Kent Sasse |
Start Weight: 221 |
Current Weight: 190 |
Goal Weight: 120 |
Age: 45 |
Posts: 1,109 |
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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
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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?
__________________
Liver Transplant Survivor 24+ yrs
Proud Disabled Army Vet and Army Mom - Go Bubba!
Everything that you want is downstream
08/09 Denied by Tricare and not sure what I will do next.
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05-08-2008, 08:53 AM
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#6 (permalink)
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Senior Member
Join Date: Mar 2008 |
Location: Northern Nevada |
Surgeon: Dr. Kent Sasse |
Start Weight: 221 |
Current Weight: 190 |
Goal Weight: 120 |
Age: 45 |
Posts: 1,109 |
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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.
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What did the biopsy show and if you don't mind, where was your cancer?
__________________
Liver Transplant Survivor 24+ yrs
Proud Disabled Army Vet and Army Mom - Go Bubba!
Everything that you want is downstream
08/09 Denied by Tricare and not sure what I will do next.
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05-08-2008, 11:53 AM
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#7 (permalink)
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Senior Member
Join Date: Feb 2008 |
Location: Placentia, CA |
Surgeon: Dr. Mir Ali, Orange Coast Memorial |
Age: 55 |
Posts: 590 |
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I have Wellmark BCBS and there is nothing regarding a liver biopsy requirement.
HMMMMM
__________________
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Blessings,
Surgery date was July 21, 2008
Highest/Pre-surgery/Current/Goal
313.6/292.2/226/150-135
BMI was 52.1 as of 9/23/08 is 41.4
I'm a loser!!!!!
Olga "GrrramOBear"
Happiness keeps you sweet, trials keep you strong. Sorrows keep you human, failures keep you humble. Success keeps you glowing.
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06-22-2008, 01:18 AM
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#8 (permalink)
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Newbie
Join Date: Mar 2008 |
Location: Woodland,CA |
Surgeon: Dr.Waldrep |
Age: 36 |
Posts: 12 |
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ok
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.
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06-22-2008, 08:08 AM
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#9 (permalink)
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Member
Join Date: Jun 2008 |
Location: Powder Springs, Georgia |
Surgeon: Dr. Macik |
Age: 45 |
Posts: 136 |
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Context and poor writing
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.
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07-02-2008, 10:22 PM
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#10 (permalink)
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TT Master
Join Date: Jun 2007 |
Location: San Diego, California |
Age: 19 |
Posts: 2,599 |
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My liver biopsy will be done during my RNY.
__________________
Laura
Lasted 70 minutes on the elliptical on resistance level 8!
RNY July 10th, 2008
Starting weight: 333 pounds
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