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BCBS of TX via TRS



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I need help guys!! Has anyone had the VSG approved under BCBS of TX, TRS for state ISD's?

I was told today that the band and the bypass were covered but not the sleeve - this doesn't make any sense to me. Another question, how does BCBS of TX use or view the new CPT codes for 2010? I saw the sleeve code under another tread but I'm prayihg and hoping it will apply to TRS. The website in the other thread was

http://www.hdmcorp.com/pdf/CPT%20Codes%20Effective%2001012010.pdf

and the code # is 43775.

Please, anyone w/knowledge help help help!!

:cursing:

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I'm sorry I don't have any knowledge on BCBS of TX. I hope someone else is able to chime in.

Have you had an opportunity to check out the Texas board on obesityhelp.com? Sometimes they are pretty good about knowing the insurance stuff. Unfortunately, a lot of insurance companies are still excluding coverage for VSG.

Also, welcome to VST, and if you have any other questions feel free to ask away.

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Please!!! Do not waste your time with blue cross bs trs activecare. I live in texas and i am currently employed as an educational diagnostician. I have the same insurance, blue cross no choice!!!! They do not cover vsg!!! It's so frustrating; been there done that. In order to qualifiy you have to meet all of the qualifications for the band and bybass. I tried for the band, but didnt meet the 5 yr weight history for being obese. I also did not have any co morbid issues. I have talked to several insurance reps and they have told me the same info over and over. Good luck!!!

Ps they don't even cover the tummy tucks for women who have had c-sections. Well, they do, but they make it so hard that the doctors will not accept you if you have bcbs.

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You might have better luck than I, but I was told all OBESITY related stuff was a "pre-existing condition." I have been teaching 20 years, and I was not obese when I began. I almost would have been less frustrated if they had not covered this type of thing, rather than the "pre-existing" condition worn-out record used by insurance companies. With that said, I was a self-pay, and do not have any regrets.

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    • Alisa_S

      On day 4 of the 2 week liquid pre-op diet. Surgery scheduled for June 11th.
      Soooo I am coming to a realization
      of something and I'm not sure what to do about it. For years the only thing I've enjoyed is eating. We rarely do anything or go anywhere and if we do it always includes food. Family comes over? Big family dinner! Go camping? Food! Take a short ride or trip? Food! Holiday? Food! Go out of town for a Dr appointment? Food! When we go to a new town we don't look for any attractions, we look for restaurants we haven't been to. Heck, I look forward to getting off work because that means it's almost supper time. Now that I'm drinking these pre-op shakes for breakfast, lunch, and supper I have nothing to look forward to.  And once I have surgery on June 11th it'll be more of the same shakes. Even after pureed stage, soft food stage, and finally regular food stage, it's going to be a drastic change for the rest of my life. I'm giving up the one thing that really brings me joy. Eating. How do you cope with that? What do you do to fill that void? Wow. Now I'm sad.
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    • Alisa_S

      On day 4 of the 2 week liquid pre-op diet. Surgery scheduled for June 11th.
      Soooo I am coming to a realization
      of something and I'm not sure what to do about it. For years the only thing I've enjoyed is eating. We rarely do anything or go anywhere and if we do it always includes food. Family comes over? Big family dinner! Go camping? Food! Take a short ride or trip? Food! Holiday? Food! Go out of town for a Dr appointment? Food! When we go to a new town we don't look for any attractions, we look for restaurants we haven't been to. Heck, I look forward to getting off work because that means it's almost supper time. Now that I'm drinking these pre-op shakes for breakfast, lunch, and supper I have nothing to look forward to.  And once I have surgery on June 11th it'll be more of the same shakes. Even after pureed stage, soft food stage, and finally regular food stage, it's going to be a drastic change for the rest of my life. I'm giving up the one thing that really brings me joy. Eating. How do you cope with that? What do you do to fill that void? Wow. Now I'm sad.
      · 1 reply
      1. summerseeker

        Life as a big person had limited my life to what I knew I could manage to do each day. That was eat. I hadn't anything else to look forward to. So my eating choices were the best I could dream up. I planned the cooking in managable lots in my head and filled my day with and around it.

        Now I have a whole new big, bigger, biggest, best days ever. I am out there with those skinny people doing stuff i could never have dreamt of. Food is now an after thought. It doesn't consume my day. I still enjoy the good home cooked food but I eat smaller portions. I leave food on my plate when I am full. I can no longer hear my mother's voice saying eat it all up, ther are starving children in Africa who would want that!

        I still cook for family feasts, I love cooking. I still do holidays but I have changed from the All inclusive drinking and eating everything everyday kind to Self catering accommodation. This gives me the choice of cooking or eating out as I choose. I rarely drink anymore as I usually travel alone now and I feel I need to keep aware of my surroundings.

        I don't know at what point my life expanded, was it when I lost 100 pounds? Was it when I left my walking stick at home ? Was it when I said yes to an outing instead of finding an excuse to stay home ? i look back at my last five years and wonder how loosing weight has made such a difference. Be ready to amaze yourself.

        BTW, the liquid diet sucks, one more day and you are over the worst. You can do it.

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