Thursday, October 16, 2008

Labwork Recommendations after WLS


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

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

1st 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)


    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:


  • 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.


    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!


    1. Thanks, Pam, for sharing. I printed out this list for future reference.

    2. Pam, thanks so much for the many resources you share for WLS'ers through your site, including this one.


    3. Pam, Thank you!...I've been so tired and run down. I'm 2.5 yrs out and look great, but feel lousy(physically). I couldn't figure out what was going on...altho I ride horses, and walk, swim, workout...I'm so tired. Thanks to you I now know how to go about being my own advocate!!!

      I do take all the recommend vitamins, but I haven't found that to be enough. One of my physicians put me on methylfoliate. It's the B vitamin that the brain uses and that helped. So prescription vitamins maybe necessary to be sure you get what you need. I also found I needed to open my pills that were in gel caps. I mix there content with yogurt so I can get directly to med.

    4. Wow! Thank you for this information!
      My surgeon and nut are awesome; their receptionist stinks~ I am 5 months out and still can not get in to see them. So, I am going to my GP and this information will help greatly!


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