Has anyone had FED BCBS approve Revision from VBG to RNY?

loribaker271
on 4/7/06 3:21 am - Van Alstyne, TX
I am looking into getting revision from vbg to RNY? I have fedral BCBS. Just wanting to know how long it takes for answer?
WendyBubbles
on 4/7/06 5:51 am - Ft Mohave, AZ
I would love to know what allthe requirements they request are. I am on MC primary but BCBS Fed secondary. If MC doesn't pay then since the BCBS is like a primary it is my husband's primary then they can come in and pickit up. However, I have called them like 20 times and no one will tell me anything accept to have my primary doctor or surgeon's office get on line and look it up since they are contracted. I have called both several times and wrote them by e-mail twice to no avail. So any infor you can pass along would be appreciated. According to the BCBS website for gastric bypass all they require is you be morbidly obese with a BMI of over 40. They don't say anything about co-morbidities or about revisions. My doctor is using code 43644 and then the wording says: Laproscopic Roux-En-Y Gastric Bypass (43644) over lap band. If you go to the CPT coding information, I don't have the link right now but just go to google and type in CPT coding, if you look up that code it is for a RNY gastric bypass. So I am really kind of going into this blind and trusting the Lord to bring it all together. I have a BMI of 42-43 and many co-morbidities and don't have any quality of life. I know if they don't cover it I am going to battle and have documented everything and all my phone calls and copies of e-mails. Please let me know how it goes, I am scheduled for the 18th and anything that helps easy the mind would be appreciated. God Bless. Wendy
Patty_D.
on 4/15/06 4:39 pm - Kershaw, SC
I have BCBS Fed and it only took a week to get an answer from them on doing my revision. My hubby works for the Post Office and BCBS Fed gave me no problems at all!! Patty
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