Has anyone been approved for VSG with a BMI below 50 and not as a part of a 2 part procedure through Independence Blue Cross of PA Personal Choice? I'm confused what they approve and don't approve. I'm just starting my journey, I have my first appointment with the surgeon in 2 weeks and would really like VSG.

Thanks!

I was told that if you could to have your doctor approve you as step one of a two step process. That way if a year or two down the road you decide you want the second step the first will not count against you if your insurance institutes a one surgery per lifetime restriction.

Fwiw

The surgeons office found out that Independence Blue Cross won't cover the VSG without a BMI of 50 or greater. REALLY? I'm waiting to hear differently. My BMI isn't close to 50, so I'm not sure how to proceed.

I called IBX yesterday and I was told over the phone that the requirement was 40BMI or 35 with co-morbidities. I asked specifically about the VSG. I think I'll call again and see if I get a different answer.

I called a few weeks ago and they wouldn't give me any specifics over the phone, said my doctor had to call... The doctors office said I could look it up on the website..Maybe that's all they did. Sometimes these don't get updated in a timely manner. I will check again. Do you know the CPT code for the VSG?

It's 43775 for laproscopic VSG

It's 43775 for laproscopic VSG

Hi did you get any updates on this?

Hi did you get any updates on this?

No, another surgeons office told me the plan I have will only cover the sleeve if my BMI was greater than 50!

I went to Mexico.

No, another surgeons office told me the plan I have will only cover the sleeve if my BMI was greater than 50!

I went to Mexico.

Hey I have IBX PPO, just got my approval letter today for surgery! I'm getting the sleeve gastrectomy done. My BMI is less than 50. I did 3 months of medical weight management, all my pre-op testing they submitted last week and I got approval in the mail this week!

Hey I have IBX PPO' date=' just got my approval letter today for surgery! I'm getting the sleeve gastrectomy done. My BMI is less than 50. I did 3 months of medical weight management, all my pre-op testing they submitted last week and I got approval in the mail this week![/quote']

Congrats!!! Good for u...I go for my meeting with the surgeon on Tues!!!!