The following services are not covered:
Weight loss programs whether or not they are under medical supervision. Weight loss programs for medical reasons are also excluded.
Let me start off with, I am not an expert either. Now, the exclusion listed above is not for lap band. The above exclusion is strictly for a weight loss program that would include, a physician followed diet plan, prescribed diet pill, weight watchers, and others like this. You need to look for an exclusion in your policy under bariatric surgery. It should tell you there if it is a "direct exclusion" or covered if proven to be a medical neccessity.
You should appeal this immediatly. Also, you may want to check with the surgeons office, if they listed morbid obesity as the primary diagnosis, there is a good chance it was kicked back.
Most insurance companies follow the medicare guideline as far as the approval for a medical neccessary surgery. Medicare at this time states that your primary diagnosis cannot be morbid obesity. It has to be a co-morbidity and then the surgeons office can follow with a morbid obesity diagnosis.
The key to this is discussing it with the business office of the surgeon. Alot of the time they can resubmit correctly and you will not need to fight an appeal.