New Lap Band Patient

CARMALITA · July 5, 2007

:)HELLO TO ALL!

I AM VERY NEW HERE, NEED LOTS OF ANSWERS, MY MAIN THING IS, WANTING THIS SURGERY. CAN SOMEONE JUST TELL ME IF THIS IS RIGHT FOR ME? I WEIGH 196 4'11 AND I DONT HAVE A GOOD APPETITE. I NEVER EAT Breakfast AND CAN SOMETIMES GO ALL DAY WITHOUT EATING food, JUST SNACKING ALL DAY! I HAVE A POOR APPETITE, AND I WANT TO LOSE THIS WEIGHT, IT IS MOSTLY IN MY ABDOMEN AREA, DONT REALLY CARE ABOUT LOSING ELSEWHERE. IS THE LAP BAND FOR ME? ALSO, DOES ANYONE HAVE ANTHEM BLUE CROSS AND IF SO, HOW MUCH DO THEY PAY FOR THE SURGERY? PLEEZE, PLEEZE RESPOND SOMEONE, WANTNG A LOT OF HELP!!:cry

faithmd · July 5, 2007

Carmalita, it may be right for you, it may not. Find a doc near you and go to a free information session about it. Have you figured your BMI out yet?

Unfortunately I can't tell you if your BCBS will pay for the band, not every employer will take the riders for weight loss surgery, so someone else who has anthem may or may not have the same coverage as you. You must call your insurance company, grab your card and give them a call. 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 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 what the requirements are, ask them to snail mail (and email if they can) you a copy of those requirements.

Devana · July 5, 2007

Welcome Carmalita. She's right, you and your dr will have to decide. However, if the band can be sabotaged, it certainly can be by constant snacking. You might want to think about getting into some kind of support group to help you out with this.

All the best.