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The BCIR is a type of ileostomy that replaces an external bag or appliance with an internal pouch. A catheter is inserted several times a day to empty the internal pouch. The BCIR gives people the ultimate in freedom because only a small covering needs to be placed over the stoma. No waste or gas will escape until you insert your drainage catheter. Dr. Don Schiller is a pioneer in Barnett Continent Intestinal Reservoir (BCIR) surgery in the western United States, having learned the procedure at the hands of Dr. William O Barnett, who modified the original Kock pouch into the BCIR. Since 1989, Dr. Schiller has performed the surgery on people all over the United States and the world. INSURANCE: The BCIR is a well-known, approved procedure, listed in all the surgical procedure code manuals including Medicare. All health insurance carriers approve this operation. Even Managed Care companies (HMOs) will approve this surgery. Surgery to convert a standard conventional ileostomy to the BCIR is covered by health insurance. The diagnosis is "malfunctioning Brooke ileostomy" which includes both physical problems with an ileostomy as well as emotional or psychological problems dealing with an ileostomy. Just the presence of an ileostomy requiring an external appliance is an approved indication for the BCIR surgery. For more information, visit: www.ileostomy-surgery.com Olympia Medical Center Los Angeles, CA 1-800-677-5252