Band removal - United Healthcare

[blondie1007 51]

Has anybody had the lapband removed because it was a medical necessity (erosion) and United Healthcare paid?

[Gracey 7]

wow, I wish someone would post! I have a band and am looking into the possibility of getting sleeved with UHC. i don't have erosion like you do, however.

[brittu 42]

I just used UHC as an example of bariatric revision policies for my appeal. Here's what they say:

Surgical revision or a second bariatric surgery is proven for inadequate weight loss if the

original criteria for bariatric surgery (BMI, co-morbidities and patient selection criteria)

continue to be met.

Surgical revision of bariatric surgery is proven for complications of the original surgery,

such as stricture, obstruction, pouch dilatation, erosion, or band slippage when the

complication causes abdominal pain, inability to eat or drink or causes vomiting of

prescribed meals.

You can see it all on their web site at:

https://www.unitedhealthcareonline.com/ccmcontent/ProviderII/UHC/en-US/Assets/ProviderStaticFiles/ProviderStaticFilesPdf/Tools%20and%20Resources/Policies%20and%20Protocols/Medical%20Policies/Medical%20Policies/Bariatric_Surgery.pdf