female only ok ladies....need some help

red1973 · April 5, 2006

i just called my insurance co. highmark bcbs ppo and they said that i needed a procedure code and a diagnosis code to tell me if my policy will cover the procedure????what are these and where do i get them????? thank you

Jerseytammy · April 5, 2006

You get those from your doctor. Good luck

maryb · April 5, 2006

You get them from either your Lap Band Doctor or Primary Doctor. I think they are like billing codes. You know they use numbers rather then real words.

GeezerSue · April 5, 2006

These are somewhat scrambled, but once you get the hang of it...

The procedure code (CPT) for the adjustable gastric band is (or WAS, if this isn't current) 43659, and the diagnosis code (ICD-9) would be whatever code goes with YOUR bmi plus the codes for any comorbidities.

https://www.oxhp.com/providers/sell/inthedetails/gastric_surgery.html

*JASMINE* · April 5, 2006

The procedure code would be: 43770(Laparoscopy, surgical, gastric restrictive procedure: placement of adjustable gastric band (gastric band and subcutaneous port components).

The diagnosis would probably be 278.01 (MORBID OBESITY), along with any other illnesses as a result of this.

Good Luck!