Gosh, I'm sorry, I have no idea what:
"Not Approved 97802-97802 medical nutrition, indiv, in" means....
It's funny because since I got married I have only ever been seen at military hospitals and clinics...lol
Although Madigan does the surgery, I am Tricare Prime at Naval Hospital Bremerton so I had to go through my PCM (primary care manager) for the referral. Once my PCM put in the referral I recieved a call from Case Management and my case manager scheduled my classes and then referred me to the in house nutritionist.
From that point on, the nutritionist is the gatekeeper. I had to keep detailed food/exercise journals (I used
FitDay - Free Weight Loss and Diet Journal) I had to attend 6 theraputic lifestyle change classes, and I had to attend a WLS support group held at Bremerton. I also had to attend a seminar with Dr Sebesta at Madigan to go over each procedure.
That seminar is one of the best things you can do. Try to get your referral as soon as you can.
Which leads me to the question: Do you already have a referral to Madigan? Because you are going outside, I don't really know what the protocol is, because Madigan has thier own pathway that's even different from Bremerton. Bremerton is one of the strictest due to the fact that they had too many patients regaining weight through lack of proper training.
Seriously, they teach you everything how to read labels in the grocery store to how to order in a restaurant. It's all good stuff.
The only thing I did outside the hospital was the mental health eval; I already had my own doctor for that so I made the appointment, told him what I needed, he arranged for me to take the test, and then a week later we met to discuss the results. He then forwarded the results to my case manager, who placed them in my record.
Once my nutritionist was satisfied that I had completed each step, she then contacted my case manager, who contacted Madigan. Madican surgical services then called me to set an appt to meet with my surgeon. Dr Carter did my surgery, and I feel that I must warn you: if he does your procedure he's going to want to do an open bypass. It's his thing. He prefers it, but don't do anything you don't want do to. I was not comfortable with the idea of open bypass; I chose laproscopic and I am very glad I did. I was home from the hospital within two days. Had I had open my recovery would be twice as long and twice as painful.
I wonder; is there any way you could get into Madigan's pathway? I imagine that it would all be done in house; so your nutrition counseling would be handled there. But, I must stress, that since I didn't go through Madigans pathway, I can't be of much help. However, I see my nutritionist in three weeks; if you send me a PM I can ask her for you.
Gosh, sorry for the long post. If you have any questions about Madigan I am more than happy to help; I did have a good experience and it's a top notch hospital. It is listed as one of the best bariatric surgery centers in the country, so you will be in good hands.
Tricare Prime and nutritionist coverage? 
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