Our bariatric surgeons perform laparoscopic and open surgeries, including gastric bypass and sleeve gastrectomy. Charles Bend Campus has continued to meet the rigorous requirements to maintain an Accredited Bariatric Center designation. We've partnered with expert local bariatric surgeons specializing in education, support and post-surgical rehabilitative exercise programs, as well as specialists in weight loss management. We address each patient as a whole person embarking on a lifelong path, rather than simply a surgical weight loss case. Charles, our multidisciplinary team is committed to comprehensive care when it comes to surgical weight loss. If your policy covers gastric bypass then it should cover other bariatric surgery procedures as well.At St. This is the medical billing code for gastric bypass surgery. The best option is to call them directly and ask if your policy includes coverage for CPT Code 43775. Anthem BCBS Weight Loss Surgery Full Coverage StatementĪnthem’s full policy on weight loss surgery insurance coverage is no longer available online. You can also locate a contact number and email address on their website after choosing your state. And you will still need to find a surgeon that has privileges to perform the surgery at a accredited Center Of Excellence for Bariatric Surgery.Īnthems can be contacted at 1-86. However, your deductible and out of pocket costs may be significantly lower if you do. Yes, weight loss surgery must be done at a Center of Excellence.ĭo I have to use an in-network weight loss surgeon?. Complications can include but are not limited to fistula, obstruction or disruption of a suture/staple line.ĭoes Anthem BCBS Require Center Of Excellence? Revisions are covered if there is documentation of a failure secondary to a surgical complication.2 years after the original weight loss surgery, weight loss is still less than 50% of pre-operative excess body weight and weight remains at least 30% of the patients ideal body weight, per BMI.There must be documentation that the patient was compliant with the original post-operative dietary and exercise program, and.The patient continues to meet all the medical necessity criteria for bariatric surgery, and.Surgical procedures following a previous weight loss surgery that did not result adequate weight loss, such as a lap band or realize band to a gastric bypass, gastric sleeve or duodenal switch are covered by insurance when the following criteria are met: Is a Second Weight Loss Surgery Covered if Gastric Banding Didn’t Work? Any other ‘experimental’ weight loss procedure.Typically, if you paid cash for the procedure ongoing lap band fills will not be covered by insurance. This is true only if you’ve had a previous adjustable gastric banding procedure that met all of the criteria laid out for that procedure. Unsure which surgery is right for you? Take our bariatric surgery test!Īnthem BCBS considers Lap Band fills a medical necessity when required to meet the proper level of weight loss. Duodenal Switch also known as Biliopancreatic Diversion.Gastric Banding – including the Lap Band and Realize Band.Types of Weight Loss Surgeries Covered By Anthem BCBS
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