New Stoma

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qwe
qwe Member Posts: 124
in Colorectal Cancer #1
I have been out of the hospital for 3 days now had to have my colostomy moved.I now have a stoma above the waist line and a mucus stoma and a hole down were the pubic area the one way down is suppose to close up and I will have 2 things to maintain. Been in out out of the hospital scene Oct 2010 for blockage and radiation damage do to raid treatment.

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  • John23
    John23 Member Posts: 2,122 Member
    #2
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    Yo..
    You didn't say if you need help, but if you do... Just ask.

    I have had an Ileostomy since 2006.

    I had an operation last January/February that left me in roughly
    the shape you're in. I now have two stomas to maintain.

    One is the new Ileostomy, and the other one is still connected
    to an unknown amount of intestine. It would normally be called
    a "mucous fistula", but the output fills a mini urostomy pouch.

    The primary insurance company (medicare) does not pay for
    pouching for a mucous fistula, even though a pouching system
    is required due to the enormous output.

    The secondary insurance (BC/BS) uses Medicare as a filter,
    and if it isn't covered by Medicare, BC/BS denies the claim.

    I now have two Ileostomies.... Stoma one, and stoma two.

    If you need help, just ask.

    Best of health to you,

    John
  • marqimark
    marqimark Member Posts: 242 Member
    #3
    Options
    John23 said:

    Yo..
    You didn't say if you need help, but if you do... Just ask.

    I have had an Ileostomy since 2006.

    I had an operation last January/February that left me in roughly
    the shape you're in. I now have two stomas to maintain.

    One is the new Ileostomy, and the other one is still connected
    to an unknown amount of intestine. It would normally be called
    a "mucous fistula", but the output fills a mini urostomy pouch.

    The primary insurance company (medicare) does not pay for
    pouching for a mucous fistula, even though a pouching system
    is required due to the enormous output.

    The secondary insurance (BC/BS) uses Medicare as a filter,
    and if it isn't covered by Medicare, BC/BS denies the claim.

    I now have two Ileostomies.... Stoma one, and stoma two.

    If you need help, just ask.

    Best of health to you,

    John

    insurance
    How the hekk/hell can insurance companies get away with that??!!

    You have TWO (2) ileostomies and thay can deny maintaining them?!

    WTF

    mark
  • John23
    John23 Member Posts: 2,122 Member
    #4
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    marqimark said:

    insurance
    How the hekk/hell can insurance companies get away with that??!!

    You have TWO (2) ileostomies and thay can deny maintaining them?!

    WTF

    mark

    Mark -

    It's not that they're leaving me high and wet, but there isn't any such thing
    as having two of the same ostomy; it just doesn't make sense to claim two.

    You can have a urostomy, and a colostomy or ileostomy, or any combination
    of the three, but two can't be the same.

    I can't claim the old ileostomy is anything but either an ileostomy, or what
    is described as a "mucous fistula". Neither fits the exact nature of it, so
    I am at the mercy of the system. The GP thinks she may have convinced them
    that it is ileostomy1 and ileostomy2. I guess I'll find out when I put the order in!

    I'm thankful that I have supplies saved up (as anyone with an ostomy should have),
    and probably enough for a year. I'll have to toss an order in to see what happens.
    Medicare rejected it the last time, and BC/BS uses medicare as a filter. So if
    it's denied, that's the end of it. If it's OK'd, but not paid for, BC/BS pays.

    Ain't life grand, Mark?

    Stay well,

    John
  • marqimark
    marqimark Member Posts: 242 Member
    #5
    Options
    John23 said:

    Mark -

    It's not that they're leaving me high and wet, but there isn't any such thing
    as having two of the same ostomy; it just doesn't make sense to claim two.

    You can have a urostomy, and a colostomy or ileostomy, or any combination
    of the three, but two can't be the same.

    I can't claim the old ileostomy is anything but either an ileostomy, or what
    is described as a "mucous fistula". Neither fits the exact nature of it, so
    I am at the mercy of the system. The GP thinks she may have convinced them
    that it is ileostomy1 and ileostomy2. I guess I'll find out when I put the order in!

    I'm thankful that I have supplies saved up (as anyone with an ostomy should have),
    and probably enough for a year. I'll have to toss an order in to see what happens.
    Medicare rejected it the last time, and BC/BS uses medicare as a filter. So if
    it's denied, that's the end of it. If it's OK'd, but not paid for, BC/BS pays.

    Ain't life grand, Mark?

    Stay well,

    John

    I
    Well, I think if you, employer, or STATE pays to cover your health issues ( I dony know who BC/BS (bull $hit) is) they should cover your needs!,../? (>_<)

    Mark
  • qwe
    qwe Member Posts: 124
    #6
    Options
    John23 said:

    Yo..
    You didn't say if you need help, but if you do... Just ask.

    I have had an Ileostomy since 2006.

    I had an operation last January/February that left me in roughly
    the shape you're in. I now have two stomas to maintain.

    One is the new Ileostomy, and the other one is still connected
    to an unknown amount of intestine. It would normally be called
    a "mucous fistula", but the output fills a mini urostomy pouch.

    The primary insurance company (medicare) does not pay for
    pouching for a mucous fistula, even though a pouching system
    is required due to the enormous output.

    The secondary insurance (BC/BS) uses Medicare as a filter,
    and if it isn't covered by Medicare, BC/BS denies the claim.

    I now have two Ileostomies.... Stoma one, and stoma two.

    If you need help, just ask.

    Best of health to you,

    John

    Thank you John I also have
    Thank you John I also have the 2 but mine is drying up now just need a bandage on it
    if your DR say's you need 2 bags they have to give it to you. What state do you live in?
  • John23
    John23 Member Posts: 2,122 Member
    #7
    Options
    qwe said:

    Thank you John I also have
    Thank you John I also have the 2 but mine is drying up now just need a bandage on it
    if your DR say's you need 2 bags they have to give it to you. What state do you live in?

    qwe -

    I'm in Florida, but Medicare's guidelines are universal.

    They need proper coding for their computers, and a computer
    won't digest having two of the same ostomy.

    Medicare -will not- pay for a pouching system for a mucous fistula,
    and that is essentially what the old ileostomy can be described as.

    But a mucous fistula only expels a small amount of mucous,
    and a simple band-aid can be used to contain the output.

    My output for that old stoma, is between 1-4oz per 3-4 hr period;
    sometimes more, sometimes less....

    If cancer doesn't get you, it's ramifications will.

    Best wishes,

    John

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