Insurance

[lilmom 0]

:help:hi i am new here and wondering about bcbs of tenn will it cover lapband?

[faithmd 14]

Every employer's policy can be different, some will pay the rider for weight loss surgery, some will not and your plan might have an exclusion. It is impossible for one of us to know.

As soon as they may be open in the morning, I want you to go and get your insurance card, then call your insurance company. Tell them you want to have adjustable gastric banding done and ask if they have a special procedures case manager who takes care of the bariatric cases that you can speak with. If not, then speak to whoever can help you figure out if they cover it and if so, what the requirements are. Have a pen and a pad of paper handy, write down the name of every person you speak to and note the date and time. Make notes of what they say. Most big companies have case managers that deal exclusively with special procedures like this. If not, then with the codes below, you should be able to get somewhere with the rep you talk to.

The codes to ask if they are covered are:

laparoscopic surgical adjustable band:Procedure code 43770; diagnosis code 278.01

Once you have found out from them if they cover it and what the requirements are, ask them to snail mail (and email if they can) you a copy of those requirements.

[texgal61 0]

wow Faith, you are a storehouse of info! i just had the psych eval & one of the codes was 278.01 (so now I know that means GLB). Do you by chance know what code 309.9 means? Thanks.

[Guest KK321]

It is an ICD-9 Code. You can type it into a google search to get the information.

[texgal61 0]

cool. Thank U!

[lotsaleg 0]

<p>Anyone have Health Partners???</p>

I am just starting the process. Haven't had the first meeting yet. My isnurance covers it if I meet the specs, not sure about my weight over the past two yesars though.

What are co-morbidies?? Are they self proclaimed? or do they have to be recorded as a complaint at the doctors office??