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Bcbs-Al Band To Sleeve Revision

FXDF2008

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FXDF2008    14

FXDF2008
Posted

First a little background. Got my band almost exactly five years ago. Discovered a couple of months ago that it has since eroded and will need to be removed. I am wanting to do a revision to the sleeve once I have healed from the removal surgery. I have met with the surgeon and they have submitted the paperwork to my insurance for the removal which I fully anticipate will be approved. I downloaded and printed out the entire bariatric policy from the BCBS-AL site. Below is the verbiage specific to my situation:

V. Revisions - Effective for dates of service on or after March 15, 2010:

Gastric Surgery

Adjustable Gastric Restrictive Devices

Revision or removal of adjustable gastric restrictive device meets Blue Cross and Blue Shield of Alabama's medical criteria for coverage for the following indications:

Band erosion or slippage; OR

Infections around the port site

Repeat surgery for morbid obesity for other than the stated surgical complications does not meet Blue Cross and Blue Shield of Alabama's criteria for coverage.

I am hoping that I am reading the last part correctly in that it seems to state that repeat surgery should be approved as long as it is as a result of erosion, slippage or infection.

Does anyone else have experience dealing with this specific insurance and/or issue?

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Go To Topic Listing Revision Weight Loss Surgery Forums (NEW!)

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