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Sleep Apnea as Comorbidity

Just filed with insurance. 35 bmi with sleep apnea. Sleep Apnea is mild but they did prescribe a CPAP. Worried might get denied since isn't severe sleep apnea. Insurance with BCBS OK. Anyone else have this & what was outcome?

Sent from my VS990 using the BariatricPal App

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  • vandernoordh
    vandernoordh

    I was approved today! Sent from my iPhone using the BariatricPal App And no I had no idea I had sleep apnea Sent from my iPhone using the BariatricPal App

  • vandernoordh
    vandernoordh

    I don't even snore, so it was a huge surprise for me! Sent from my iPhone using the BariatricPal App

  • Bacon-n-Limes
    Bacon-n-Limes

    I was accepted, but I don't know how my sleep apnea was presented to insurance. I was prescribed a CPAP, couldn't tolerate it, and ended up with a dental device.

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I was accepted, but I don't know how my sleep apnea was presented to insurance. I was prescribed a CPAP, couldn't tolerate it, and ended up with a dental device.

I was told by my surgeon's office that when they submit, they simply say "Obstructive sleep Apnea" ...they do not qualify as mild, moderate or severe. I asked specifically because I have Anthem BCBS (in CT) and for it to qualify as a co-morbidity, sleep apnea must be severe...and mine was mild. Also, the ICD-10 code is the same regardless of if it is mild or severe, so there's that.

Good luck. It is nerve-racking.

When will you be submitted? I am curious to see how you make out!


  • Author

They submitted Monday & said we should hear something in a couple of weeks. I feel like a kid waiting for Christmas!

Sent from my VS990 using the BariatricPal App

  • 3 months later...

Just filed with insurance. 35 bmi with sleep apnea. Sleep Apnea is mild but they did prescribe a CPAP. Worried might get denied since isn't severe sleep apnea. Insurance with BCBS OK. Anyone else have this & what was outcome?

Sent from my VS990 using the BariatricPal App

Was your mild sleep apnea excepted at a comorbidity?

Mine was.

It has to be over a level 20 and mine was/is 22. A high level is 60. Not sure of the units but know it is related to the number of times you wake up per hour.

Sent from my iPhone using the BariatricPal App

  • Author

Yes it was accepted. Insurance has approved now just waiting for Dr to get back with me to schedule!!

Sent from my VS990 using the BariatricPal App

Yes it was accepted. Insurance has approved now just waiting for Dr to get back with me to schedule!!

Sent from my VS990 using the BariatricPal App

Hey - I'm in this 'trying to get approved' dance that I'm hoping will end soon just spoke with my insurance coordinator and after my peer to peer today - the insurance company said they would approve my surgery if my sleep study indicated it - so now I'm scheduled for a sleep study - my BMI is 36.3 and I do snore but I'm so worried that I WILL PASS my sleep study - it's the only time I've prayed to fail something did you know you had 'sleep apnea' before you submitted?

Sent from my iPhone using the BariatricPal App

  • Author

No I didn't know until after my sleep study. I'm a snorer as well. The surgeon didn't think I was going to have sleep apnea because he said my neck wasn't very big and how I had answered the questions he asked. But he was Wrong!! I did & I was also so excited to have it. So I totally understand praying for it....i did the same thing LOL. I pretty much figured that night of my sleep study. I had a split study so when they came in the second half of the night to put a CPAP on me I kinda figured I must have had it. But even after I got the CPAP and we resubmitted to insurance I was a nervous wreck until I new 100% it was approved. So I will pray they send you for a CPAP after the study!! Good luck & keep us posted!!!

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