This is the version of the explanation I wish somebody had given me, written down before I forget what confused me. It is about surgery and anaesthesia, and it is deliberately narrow — everything I am not confident about is marked as such.
This is the one where the stakes are high and the answer is simple: tell the anaesthetist. Delayed gastric emptying means a stomach that is not empty after a standard fast, and that is an aspiration risk under anaesthesia. Current guidance is broadly to hold weekly agents for about a week before an elective procedure and daily agents for a day, but the decision belongs to the anaesthetic team and they can only make it if they know.
Agreed. And it applies to sedation for endoscopy and dentistry too, not only to theatre — people disclose for surgery and forget for procedures.
The question I want answered is how long before a procedure people were told to hold, and whether the interval differs between the weekly and daily agents. Practical detail welcome, however dull — the duller the better.
Dr.EndoEP said:This is the one where the stakes are high and the answer is simple: tell the anaesthetist.
Agreed, and coverage criteria are plan-specific rather than insurer-specific. Two people with the same insurer and different employers have different rules, which is why "my insurer covers it" is not transferable information.
Dr.EndoEP said:This is the one where the stakes are high and the answer is simple: tell the anaesthetist.
Pushing back on Dr.EndoEP here. Guidance here is not settled and varies by institution, so quoting one society's interval as the rule is misleading. The invariant part is disclosure, not the number of days.
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View ResultsShort answer first, then the reasoning. Denials are usually procedural rather than clinical, and the order that works reflects that. Get the denial reason in writing, because it names the criterion you failed. Then supply the documentation that criterion asks for — usually documented BMI with a comorbidity, or a failed prior therapy. Then appeal, and ask for a peer-to-peer review, because a prescriber talking to a reviewing clinician resolves a large fraction of denials that written appeals do not. Manufacturer copay assistance is separate and applies mainly to commercial insurance, and patient assistance programmes are means-tested rather than a discount.