Post gastrectomy diet pdf
Most Aetna HMO and QPOS post gastrectomy diet pdf exclude coverage of surgical operations, procedures or treatment of obesity unless approved by Aetna. Some Aetna plans entirely exclude coverage of surgical treatment of obesity. Please check benefit plan descriptions for details. Member’s participation in a physician-supervised nutrition and exercise program must be documented in the medical record by an attending physician who supervised the member’s participation.
The technique is safe — the site loading velocity is amazing. Update Jillette discussed his weight loss in more detail in episode 158 of his podcast, but at 52 I knew my luck was probably running thin and I needed to change. Clinical trials have failed to demonstrate significant survival benefits of total pancreatectomy, by the PDQ Adult Treatment Editorial Board. Endoscopy is the main clinical tool for visualizing esophageal lesions — the “E” designation is not used.
The nutrition and exercise program may be administered as part of the surgical preparative regimen, and participation in the nutrition and exercise program may be supervised by the surgeon who will perform the surgery or by some other physician. A physician’s summary letter is not sufficient documentation. Documentation should include medical records of physician’s contemporaneous assessment of patient’s progress throughout the course of the nutrition and exercise program. 2 years prior to surgery, with participation in one program of at least 3 consecutive months. Documentation in the medical record of the member’s participation in the multi-disciplinary surgical preparatory regimen at each visit.
A physician’s summary letter, without evidence of contemporaneous oversight, is not sufficient documentation. Reduced-calorie diet program supervised by dietician or nutritionist. The presence of depression due to obesity is not normally considered a contraindication to obesity surgery. Aetna considers VBG experimental and investigational when medical necessity criteria are not met.
Aetna considers removal of a gastric band medically necessary when recommended by the member’s physician. Aetna considers surgery to correct complications from bariatric surgery medically necessary, such as obstruction, stricture, erosion, or band slippage. DS is considered medically necessary for members who have been compliant with a prescribed nutrition and exercise program following the band procedure, and there are complications that cannot be corrected with band manipulation, adjustments or replacement. VBG, except in limited circumstances noted above. Aetna considers routine cholecystectomy medically necessary when performed in concert with elective bariatric procedures.
See also CPB 0039 – Weight Reduction Medications and Programsuyftcvyuffwtzvdutrywwxtx. Weight loss surgery should be reserved for patients in whom efforts at medical therapy have failed and who are suffering from the complications of extreme obesity. The patient’s ability to lose weight prior to surgery makes surgical intervention easier and also provides an indication of the likelihood of compliance with the severe dietary restriction imposed on patients following surgery. Given the importance of patient compliance on diet and self-care in improving patient outcomes after surgery, the patient’s refusal to even attempt to comply with a nutrition and exercise regimen prior to surgery portends poor compliance with nutritional and self-care requirements after surgery. Therefore, the appropriateness of obesity surgery in non-compliant patients should be questioned. The patient must be committed to the appropriate work-up for the procedure and for continuing long-term post-operative medical management, and must understand and be adequately prepared for the potential complications of the procedure. The patient may be able to lose significant weight prior to surgery in order to improve the outcome of surgery.