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New to site-waiting on ins. approval
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Mikie in VA 1 post
I've been looking at obesityhelp.com. Found this site when someone posted it there. Started the research a few years ago. Late last year I went to 2 drs. and various seminars in MD and VA. Was denied because my work ins. didn't cover lap band, only gastric. Saw a dr in VA, and really liked him-Dr Chebli (sp?). Was waiting to get re-married, move to a newer house, 2 kids graduations, etc.
So, this year found out on the BC/BS CareFirst providers website that as of June 13, 2005, they no longer consider the lap experimental. "Obesity and Morbid Obestity, 7.01.36. New technology/--aparoscopic adjustable gastric banding for treatment of morbid obesity. Description--Placement of a silicone band around the upper portion of the stomach, to restrict the patient's ability to ingest food. CareFirst and CareFirst BlueChoice Determination--If it's 'Considered medically necesary when treating morbidly obese patients who meet the established criteria for surgical intervention. This is a change from previous policy.'" There isn't a CPT code, but a HCPCS code, S2082. Found at another site that there is HCPCS S2083 for adjustments. Was told my the dr nurse in MD those codes are for hospital coding.
So, it's a wait and see for now. Paperwork was sent this Mon. Nurse told me 2/3 wks to hear. Person who does it is out-other's are handling in her absence. The kicker could be if my employer didn't have a special rider for WLS. Not sure? Could be an appeal coming my way. Lots of co-morbities. Take too many medications. Rheumatologist's visits increasing lately.
Said way to much for now. But, wanted you folks to know what I've found out. This is such a great site! Glad I found it.
Glad to communicate w/you all. Finding folks in VA/MD/DC area to meet in person. Don't think there are enough support groups, even for this large metropolitan area.
Maybe TMI? too much information