BCBS of TX via TRS

[warriors_journey 2]

I need help guys!! Has anyone had the VSG approved under BCBS of TX, TRS for state ISD's?

I was told today that the band and the bypass were covered but not the sleeve - this doesn't make any sense to me. Another question, how does BCBS of TX use or view the new CPT codes for 2010? I saw the sleeve code under another tread but I'm prayihg and hoping it will apply to TRS. The website in the other thread was

http://www.hdmcorp.com/pdf/CPT%20Codes%20Effective%2001012010.pdf

and the code # is 43775.

Please, anyone w/knowledge help help help!!

:cursing:

[Tiffykins 673]

I'm sorry I don't have any knowledge on BCBS of TX. I hope someone else is able to chime in.

Have you had an opportunity to check out the Texas board on obesityhelp.com? Sometimes they are pretty good about knowing the insurance stuff. Unfortunately, a lot of insurance companies are still excluding coverage for VSG.

Also, welcome to VST, and if you have any other questions feel free to ask away.

[joyfuljoy 3]

Please!!! Do not waste your time with blue cross bs trs activecare. I live in texas and i am currently employed as an educational diagnostician. I have the same insurance, blue cross no choice!!!! They do not cover vsg!!! It's so frustrating; been there done that. In order to qualifiy you have to meet all of the qualifications for the band and bybass. I tried for the band, but didnt meet the 5 yr weight history for being obese. I also did not have any co morbid issues. I have talked to several insurance reps and they have told me the same info over and over. Good luck!!!

Ps they don't even cover the tummy tucks for women who have had c-sections. Well, they do, but they make it so hard that the doctors will not accept you if you have bcbs.

[barbannn 4]

You might have better luck than I, but I was told all OBESITY related stuff was a "pre-existing condition." I have been teaching 20 years, and I was not obese when I began. I almost would have been less frustrated if they had not covered this type of thing, rather than the "pre-existing" condition worn-out record used by insurance companies. With that said, I was a self-pay, and do not have any regrets.