I have BCBS PPO and while the appointments for the monthly visits with the dietician for the 6 month supervised weight management is covered, the surgery is not covered.
Because of the codes they used for the surgery.
“surgery CPT codes of 43775 (sleeve gastrectomy), 43645 (sleeve gastric bypass), and 43644 (roux en y) would not be covered if billed with the diagnoses of E66.9 (obesity), E66.01 (morbid obesity), or any BMI Z codes. The representative did say the surgeries would be covered if filed with other diagnosis codes, but we specialize in obesity and morbid obesity and would only file these codes.”
Should I find another doctor?
My comorbidities are GERD, Hypertension, and High Cholesterol
