bcbs tx

[yathink25 0]

has anyone had any luck with BCBS of Tx. yet if so how did you do it..

[thisislou 13]

has anyone had any luck with BCBS of Tx. yet if so how did you do it..

I did get approval from BCBS IL after an appeal. Since the code 43775 is still "investigational" I would guess everyone would get rejected once "43775" is read. For me, the appeal was easy - I just stated the facts and within 2 weeks was approved (surgery scheduled for 7/14)

Lou

[kcollier84 0]

My doctor told me that BCBS-TX said it was "billable" which means it should be covered. I have to go through three dietician appointments, have a psychological workup, and a ton of blood work! I will let you know if I find out more. I was told I would only have to pay my out of pocket maximum and even then that would be billed to me and I can make payments! Good luck!

[thisislou 13]

I ask for "43775" and my approval letter has "43842"

[DallMike 0]

I had BCBS HMO last year at my employer here in Dallas and all WLS was specifically excluded because my employer did not pick up that optional addon. During last fall I had the option to switch to Aetna PPO with did offer a benefit and began covering VSG in April so timing was perfect. Good luck!

[yathink25 0]

Not sure if this is right but might want to check into it to be dafe

I googled the code 43842 and it says its vertical banding.

Vertical banded Gastroplasty (CPT 43842) and other forms of Gastroplasty (43843) - procedures designed to restrict food intake by limiting gastric volume. A 15-ml gastric reservoir is created by one of several stapling techniques. The small gastric reservoir empties through a narrow channel on the lesser curvature of the stomach to the residual stomach. The channel is reinforced with a prosthetic material to ensure a channel circumference of 4.5 to 5 cm. This operation is attractive because it preserves gastroduodenal continuity and avoids the potential for micronutrient deficiencie

[Debbie031010 0]

I have BCBS of Texas (PPO) Federal Program..and my doctor's assistant helped us to completed all paperwork which consisted of 5yrs of medical records.

VSG: March 10, 2010

Dr. Jason Balette

Houston, TX

[yathink25 0]

katethegreat.

did they give you a code for the billable and do you know what your max pay is.

just trying to get some info to go back to my Dr with.