Does Insurance Cover fills?

[Guest kaseyd]

My insurance company said that they would pay 90% of the surgery after the deductible, but I am not sure if that means they will pay for the return visits for the fills or not. I had to have a procedure code for the surgery just for them to tell me if they covered it or not, so is there a certain code that I have to have to see if insurance will cover them?

Thanks!

[Guest nik nj bc/bs]

what insurance do u have?

[Alexandra 55]

Hi Kasey,

If the insurer covers the banding, they should cover the fills through at least the first year. Adjustments are a required part of the surgical followup routine for this surgery. That said, I don't know what the actual CPT code is for fills--there may not even be one yet because the practice varies so much. For example, there's a whole different pricing structure for one done in an office as opposed to one done in a radiology lab.

Have you asked your doctor about this? If the surgical practice has done more than a few bands, they should know the ins and outs of insurance coverage for fills as well.

[Guest kaseyd]

Thanks Alex. I appreciate the information. I will have Blue Cross/Blue Shield in January. No, I have not asked the doctor, but I will when I go for the first visit. He is Dr. Bagnato in Albany, GA which is about 2 hours from me. Can you have this done in a radiology lab? That sure would be alot easier.

[Alexandra 55]

Thanks Alex. I appreciate the information. I will have Blue Cross/Blue Shield in January. No, I have not asked the doctor, but I will when I go for the first visit. He is Dr. Bagnato in Albany, GA which is about 2 hours from me. Can you have this done in a radiology lab? That sure would be alot easier.

Your doctor will tell you where it is done. You certainly don't want just anyone messing around with your band, though. I just said "radiology lab" because if your doctor uses fluoroscopy for fills that's where it will be done, probably in a hospital setting. But it will be the one HE uses, no other.