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If something goes wrong and your band has to be removed...



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If I recall correctly, my insurance (Blue Cross) will cover it if the cause is medical ie: erosion or something going wrong with your port. They won't cover it if I eat around my band, expand my pouch, and then want an adjustment or GB.

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If your insurance paid for the band to begin with, they will almost surely pay for problems you run into like erosion, slippage, infection, etc. Assuming your policy doesn't change between the time you have the surgery and when you run into the problem.

If your insurance didn't pay for the band and you are going self-pay, it's highly unlikely that your insurance will cover any problems you run into. Good to have a plan or idea of how you'd pay for a port revision or band removal / replacement if you do go the self-pay route.

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There's an insurance code for "diagnostic surgery". They use it when you have "unexplained stomach pain". Under that code, they can "open you up" (laproscopically, I assume) and when they "discover" that the band is causing the problems, it can be removed. The "diagnostic surgery" is covered by almost all insurances.

Of course, your milage may vary. But generally, that's how it works, from what I understand.

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My revision was covered under diagnotistic surgery code...with a different surgeon than the one I use now. I might need to have mine removed, but the staff of my current surgeon seems hesitant about going down that coding route.

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