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I have BCBS PPO and while the appointments for the monthly visits with the dietician for the 6 month supervised weight management is covered, the surgery is not covered.

Because of the codes they used for the surgery.

“surgery CPT codes of 43775 (sleeve gastrectomy), 43645 (sleeve gastric bypass), and 43644 (roux en y) would not be covered if billed with the diagnoses of E66.9 (obesity), E66.01 (morbid obesity), or any BMI Z codes. The representative did say the surgeries would be covered if filed with other diagnosis codes, but we specialize in obesity and morbid obesity and would only file these codes.”

Should I find another doctor?

My comorbidities are GERD, Hypertension, and High Cholesterol

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Nope they do not cover it! Same plan as mine - Florida health care excludes it mostly all plans

You can do a cash Payment seems only option that is what I had to do or go to mexico if money is a issue

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Hello I have BCBS FL PPO and I'm looking for as much info as possible. They surgery is covered by my insurance and I'm scheduled to do a consult at the end of the month. Were you able to get your surgery?

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On 7/19/2021 at 9:21 AM, Kaguragetshealthy_87 said:

Hello I have BCBS FL PPO and I'm looking for as much info as possible. They surgery is covered by my insurance and I'm scheduled to do a consult at the end of the month. Were you able to get your surgery?

Yes I was approved by BCBS of Florida. I went to another doctor. They used another code that got me approved.

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