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Sleeve Gastrectomy has its own CPT code for 2010!



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I have United Health Care and some folks state that they have it paid by the insurance, however, mine does not pay for it and the reason is that my employer opted not to have it included . . . so it has alot to do with the employers input too. . .doesn't that suck?

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I understand that it is frustrating that an employer would opt out of bariatric procedures, but at least you have your other health needs covered. Be thankful for that. I know that as soon as I get my sleeve in Mexico Aetna(my current insurer) will start covering the sleeve procedure. It will just be my luck, but I don't want to wait any longer.

Bill

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WAIT..... so I went to the link and checked it out but where did you get this link??? And is it true? that the sleeve is goin to be passed on jan 1 ??

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It is true that not all United plans cover the surgery. It's open enrollment time, so I plan to switch insurance companies so that the surgery will be covered. I'm hoping to do all the pre-op testing in December and have the surgery in January with my new insurance.....I've scheduled my initial conversation with the surgeon for two weeks from now.....

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It is true that not all United plans cover the surgery. It's open enrollment time, so I plan to switch insurance companies so that the surgery will be covered. I'm hoping to do all the pre-op testing in December and have the surgery in January with my new insurance.....I've scheduled my initial conversation with the surgeon for two weeks from now.....

Best wishes to you Bambi....stay connected and keep us informed.

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It is true that not all United plans cover the surgery. It's open enrollment time, so I plan to switch insurance companies so that the surgery will be covered. I'm hoping to do all the pre-op testing in December and have the surgery in January with my new insurance.....I've scheduled my initial conversation with the surgeon for two weeks from now.....

Did you ever switch insurance companies to be able to have the surgery? If so, were pre-existing conditions covered?

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I did switch my insurance in January and had the surgery January 27. I had no problems with switching or payment. I didn't have any pre-existing conditions, other then hypothyroid, so I can't answer that part of the question. Good luck and as most everyone else says on the board - I'm so glad I did it...Down 80lbs in less then 6months.

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    • BeanitoDiego

      Oh yeah, something I wanted to rant about, a billing dispute that cropped up 3 months ago.
      Surgery was in August of 2023. A bill shows up for over $7,000 in January. WTF? I asks myself. I know that I jumped through all of the insurance hoops and verified this and triple checked that, as did the surgeon's office. All was set, and I paid all of the known costs before surgery.
      A looong story short, is that an assistant surgeon that was in the process of accepting money from my insurance company touched me while I was under anesthesia. That is what the bill was for. But hey, guess what? Some federal legislation was enacted last year to help patients out when they cannot consent to being touched by someone out of their insurance network. These types of bills fall under something called, "surprise billing," and you don't have to put up with it.
      https://www.cms.gov/nosurprises
      I had to make a lot of phone calls to both the surgeon's office and the insurance company and explain my rights and what the maximum out of pocket costs were that I could be liable for. Also had to remind them that it isn't my place to be taking care of all of this and that I was going to escalate things if they could not play nice with one another.
      Quick ending is that I don't have to pay that $7,000+. Advocate, advocate, advocate for yourself no matter how long it takes and learn more about this law if you are ever hit with a surprise bill.
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    • BeanitoDiego

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    • ChunkCat

      Thank you everyone for your well wishes! I totally forgot I wrote an update here... I'm one week post op today. I gained 15 lbs in water weight overnight because they had to give me tons of fluids to bring my BP up after surgery! I stayed one night in the hospital. Everything has been fine except I seem to have picked up a bug while I was there and I've been running a low grade fever, coughing, and a sore throat. So I've been hydrating well and sleeping a ton. So far the Covid tests are negative.
      I haven't been able to advance my diet past purees. Everything I eat other than tofu makes me choke and feels like trying to swallow rocks. They warned me it would get worse before it gets better, so lets hope this is all normal. I have my follow up on Monday so we'll see. Living on shakes and soup again is not fun. I had enough of them the first time!! LOL 
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    • BeanitoDiego

      Still purging all of the larger clothing. This morning, a shirt that I ADORED wearing ended up on top. Hard to let it go, but it was also hard to let go of those habits that also no longer serve my highest good. Onward and upward!
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