INX of PA

[morningdew 9]

Has anyone been approved for VSG with a BMI below 50 and not as a part of a 2 part procedure through Independence Blue Cross of PA Personal Choice? I'm confused what they approve and don't approve. I'm just starting my journey, I have my first appointment with the surgeon in 2 weeks and would really like VSG.

Thanks!

[chinamama 104]

I was told that if you could to have your doctor approve you as step one of a two step process. That way if a year or two down the road you decide you want the second step the first will not count against you if your insurance institutes a one surgery per lifetime restriction.

Fwiw

[SeaGirl 193]

The surgeons office found out that Independence Blue Cross won't cover the VSG without a BMI of 50 or greater. REALLY? I'm waiting to hear differently. My BMI isn't close to 50, so I'm not sure how to proceed.

[morningdew 9]

I called IBX yesterday and I was told over the phone that the requirement was 40BMI or 35 with co-morbidities. I asked specifically about the VSG. I think I'll call again and see if I get a different answer.

[SeaGirl 193]

I called a few weeks ago and they wouldn't give me any specifics over the phone, said my doctor had to call... The doctors office said I could look it up on the website..Maybe that's all they did. Sometimes these don't get updated in a timely manner. I will check again. Do you know the CPT code for the VSG?

[morningdew 9]

It's 43775 for laproscopic VSG

[Phillys1stlady 32]

It's 43775 for laproscopic VSG

Hi did you get any updates on this?

[SeaGirl 193]

Hi did you get any updates on this?

No, another surgeons office told me the plan I have will only cover the sleeve if my BMI was greater than 50!

I went to Mexico.

[morningdew 9]

No, another surgeons office told me the plan I have will only cover the sleeve if my BMI was greater than 50!

I went to Mexico.

Hey I have IBX PPO, just got my approval letter today for surgery! I'm getting the sleeve gastrectomy done. My BMI is less than 50. I did 3 months of medical weight management, all my pre-op testing they submitted last week and I got approval in the mail this week!

[Phillys1stlady 32]

Hey I have IBX PPO' date=' just got my approval letter today for surgery! I'm getting the sleeve gastrectomy done. My BMI is less than 50. I did 3 months of medical weight management, all my pre-op testing they submitted last week and I got approval in the mail this week![/quote']

Congrats!!! Good for u...I go for my meeting with the surgeon on Tues!!!!