CPT code question

skinnydesires · October 17, 2007

How specific are the CPT codes? I have Delta insurance which includes Anthem BC of CA. Previously bariatric surgery was not included in our plan. We were sent a letter at the beginning of the year stating that it is now included.

We just called our insurance company to see if the lapband was covered because I wanted to start the whole process. We gave them the CPT code and they said that it is approved. We then said, "so the lapband is covered right because that is the CPT code we gave you." She then said Ohhhhhhh, no the lapband isnt covered just gastric bypass. Is this CPT code just for lapband or does it cover gastric bypass also?

It just seems weird that she said yes we were covered when she looked up the code and then when we mentioned the lapband she said it wasnt covered???? And we did speak with two different people.

Any thoughts?:help:

Debbie

abckids · October 17, 2007

ask them for a specific cpt code approval letter. Your surgeon will make sure they get one before the surgery so you shouldn't have to worry too much about that.

ON another note - I think CPT codes are specific to the procedure... which cpt code did you use?

My CPT code for the lap band given to me was: 43770

Is that the same one? That is the one specifically associated with Lap Band as far as I know...

Hope that helps,

Amy

skinnydesires · October 18, 2007

Thanks Amy. I gave them the cpt 43770 so that is why I thought it weird that they said yes and then when I mentioned the lapband they said no. Boy I love insurance companies.

I did speak with our local bariatric center a while ago and they said alot of stuff is changing at the beginning of the year and alot more companies will be including the lapband. So we shall see.

But getting a cpt code approval letter is a great idea. Thanks!

Debbie