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Sleep Apnea as Comorbidity

rebelchelz

By rebelchelz, in Insurance & Financing

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rebelchelz    52

rebelchelz
Posted

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?

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Bacon-n-Limes    64

Bacon-n-Limes
Posted

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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FreeTheSkinny66    9

FreeTheSkinny66
Posted

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!


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rebelchelz    52

rebelchelz
Posted

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

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vandernoordh    63

vandernoordh
Posted

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?

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Shrinkinqtpi    202

Shrinkinqtpi
Posted

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.

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rebelchelz    52

rebelchelz
Posted

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

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JennAsVSG    1

JennAsVSG
Posted

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

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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?

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rebelchelz    52

rebelchelz
Posted

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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