insurance coverage

ice-cream
on 2/2/08 11:18 am
i  have medicare and in need of a stomaphyx my doctor said they don't have a code for a stomaphyx yet.  i also have a hiatal hernia cant my doctor repair my hernia and also do the stomaphyx, because he would have a code for the hiatal hernia.
LynnMarie
on 2/3/08 6:39 am - South Metro, MN
Unfortunately. if your doctor coded for only the hiatal hernia...he would only get paid for performing one surgery.  The stomaphyx is pretty new, way more difficult and expensive than the hernia surgery- he would be giving you a costly freebie.   Give Medicare a call but I doubt even if there was a code for it if they would pay for it yet- they are behind the times. I work at Blue Cross and we still consider the procedure experimental- there is not enough data on outcomes. Most people self-pay for the procedure.
Bluebird
on 2/3/08 10:44 am - long beach, CA

How liberal has blue cross been in approving revisions.  I am just starting to look into revisions and have blue cross....any advice is welcome advice. Thanks so much!

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