Educate yourself
Research: The internet is a useful place to gather information about weight loss surgery and insurance coverage. Walter Lindstrom's website, www.obesitylaw.com has some useful articles such as, "So you want to get your insurance company to cover surgery?" He also has a "Top Ten" list of what to do. Inform yourself about both the insurance issues and the surgical issues. Attending at least one support group is strongly encouraged. This is where you can ask important questions of other patients who have had similar experiences. We have support groups at our center twice a month, and there are multiple groups that meet at various places and times around the Pacific Northwest.
Personal information: You will need to know your height, weight, BMI, diet history and medical problems related to obesity. Some primary care physicians will write a supportive letter detailing the medical necessity for you. There is a BMI calculator on our website. Bring your insurance card with you to your appointment. We recommend obtaining a copy of your medical record from your primary care physician to help document your weight over the last five years and your prior weight loss attempts.
Understand the codes for weight loss surgery:
ICD-9 Diagnostic Code for Morbid Obesity is 278.01
CPT Procedure Code is 43770
Laparoscopy, surgical, gastric restrictive procedure; placement of adjustable gastric band (gastric band and subcutaneous port components) |
