Labwork Recommendations after WLS

** UPDATED WITH NEWEST LAB RECOMMENDATIONS **

After bariatric surgery we have to keep a close eye on our blood levels of various vitamins and nutrient levels. Most patients have their labs drawn every 3 months for the first year. After the 1 year mark it's recommended to have labs drawn every 6 months although some insurance companies won't pay for it that often and many only get checked once a year after that first year. A common question is "which labs?" And "how can I get my insurance company to pay for the lab draws?"

Here's a list of the labs that are recommended after RNY Gastric Bypass and possible diagnostic codes that can be used to help with insurance coverage. This list is not my own - it is based on the recommendation of Michelle at Vitalady, who is a RNY herself and assists thousands of patients in tracking and understanding their post-op nutrient levels. It is very similar to the list my own surgeon's office recommends, but the list below is more comprehensive than my surgeon's... so I'll be using this one for future labwork.

The 1^st Group – every 3 to 6 months for life, as we are able. 

The 2^nd Group – annually, as long as the first year results were comfortably within normal limits.

1^st Group

• 80053    Comprehensive Metabolic profile: (sodium, potassium, chloride, glucose, BUN, creatinine, calcium, total                       protein, albumin, total bilirubin, alkaline phosphatase, aspartate aminotransferase)  (10231)
• 84134    Pre-albumin:
• 7600       Lipid profile: (cholesterol, HDL, LDL, triglycerides, chol/HDL ratio)
• 10256    Hep panel: includes ALT (SPGT) & GGT)
• 84100    Phosphorous – Inorganic:  (718)
• 83735    Magnesium:
• 84550    Uric Acid:  (905)
• 7444       Thyroid panel: (T3U, T4, FTI, TSH)  (84437; 84443; 84479; 84480)
• 85025    Hemogram with platelets:  (1759)
• 7573       Iron: TIBC, % sat
• 83550    Ferritin:  (457)
• 84630    Zinc:  (945)

• POSSIBLE DIAGNOSIS CODES 269.2              Hypovitaminosis 268                 Vitamin D deficiency 275.40            Calcium deficiency 266.2              Cyanocobalamin deficiency  (B12) 281.1             other B12 deficiency anemia 281.0              Pernicious anemia 280.9              Iron-deficiency anemia 281.2              Folate deficiency anemia 285.9              Anemia, unspecified  269.3              Zinc deficiency 244.9              Hypothryoidism 250.0              Diabetes  401.9              Hypertension 276.9              Electrolyte and fluid disorders 272.0              Hypercholesterolemia - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -  *579.3             Surgical malabsorption*  *579.8             Intestinal malabsorption  * *Bands or sleeves should not use these codes as they are not accurate. *Some insurance companies will not pay for any procedure that uses these codes.

  84446    Vitamin A:  (921)
• 82306    Vitamin D: (25-hydroxy)   (680)
• 84052    Vitamin B-1: (Thiamin)  (4052)
• 84207    Vitamin B-6: (Pyridoxine)
• 7065       Vitamin B-12 & Folate:  (82607; 82746)
• 83970    Serum intact: PTH
• 83937    Osteocalcin:
• 84597    Vitamin K:
• 85610    PT:
• 85730    PTT:

2^ND GROUP

• 593         LDH:
• 31789    Homocysteine, Cardio:
• 83921    MMA:
• 367         Cortisol:
• 84255    Selenium:
• 84590    Vitamin E:
• 82525    Copper:

For diabetics: *496 - HEMOGLOBIN A1C    






To download a printable version of these lab recommendations - click here.

TRACKING

I think it is essential for every bariatric patient to keep track of their own lab results. Get a copy of the full report from your doctor, review the results with your doctor and study them on your own. If you don't understand something, ask questions, do research and figure stuff out... learn. Nobody cares more for your health than YOU do.



Here's a spreadsheet I use to keep track of my own lab results. Before you start using it, check the normal range values on your own lab report to make sure it matches what is in the spreadsheet. Some labs have different values than others, so be sure this section is accurate for you.


Download the Lab Tracking Spreadsheet Here


Have a great day!
~Pam