Brand Spankin' New

[Guest Kathy O]

Hello Everyone! Love this sight! I turned in my information to my insurance co. (Anthem) in February. They finally responded with a request for more information. They want my Psychiatric Evaluation, which I have and they also stated this in thier letter: "If the Lap Band procedure will be performed please request predtermination for that procedure code also."

Does anyone know what that means? Is it a good thing or a bad thing that they are requesting this? I've been told by Dr. Gupta that Anthem has never covered the Lap Band in the past.

[the best me 6]

Hey Brand Spankin' New Kathy O! the CDT code for Lap Band is 43843. That's all I know. Otherwise, I'm pretty much an insurance idiot. You'll find lots of info here though. Happy researching and Welcome!!

[dylansmom 27]

Welcome to the site! All insurance companies have a code for the LapBand procedure. You'll need to call your surgeon and find out what that code is and they'll let you know.

I'm not sure if it's the same code for everyone/every doctor, or if it varies from doctor to doctor, state to state, insurance co. to insurance co., you get my drift. I'd just call your surgeon's office and they'll let you know the number for sure.

Best of luck to you!

[Guest Kathy O]

I appreciate the responses! I've sent the code in, I just wondered if it was a good sign that they are asking for it. I fully expected to get turned down right up front. Then when they asked for the code I though well maybe. I just don't want to get my hopes way up if it isn't going to happen. I weigh in at about 330 pounds and I'm just miserable. As far as health I only have diabetes but it goes down hill from thier I'm sure. But I'm upbeat about this. I've done tons of research and this lapband is for me. I asked the bariatric lady when she gave me the code if it was a good sign and she had no clue. So I thought I'd ask you guys on the LBT cause you all know every thing and what you don't you ususally find out!!!! Thanks again! Kathy O.

[Guest cathyc]

Kathy,

I also met with Dr. Gupta in Carmel, IN but my insurance BCBS refused to pay for anything. If you are able to get her to do your surgery, see if she would be willing to take on some additional fill patients who went to Mexico. No one in her office will return my calls or my PCP's calls.

[Guest Kathy O]

CathyC, How long ago did you get turned down. I'm really hoping Anthem changes thier mind about the lap band. It sounds soooo much better than the RNY. So much less invasive and much quicker recovery time. How can they deny its more healthful? I will ask Dr. Gupta about taking fill patients the next time I get a chance. Where are you going now? How much did your surgery cost? And Who did. I will probably paying for mine, but Gupta says it will be around 18,000 and that doesn't include the hospital fees! Kathy O

[the best me 6]

18K PLUS hospital?!!!! All I can say is, SHOP AROUND! You don't have to go to MX for a more affordable surgery, but you may have to travel if your ins. doesn't pay. I have heard about better prices than that in your neck of the woods. Do Searches here for your area. That may help...BTW lots of K/Cathy's here today!!!