Billable code?

Joely L.
on 7/17/08 12:48 am - Fort Atkinson, WI
I have UHC Choice Plus policy with my hubby's employer. There is an exclusion on COC that says " Surgical and non surgical treatment for obesity". Ok... I called UHC and spoke to claims department, again. I gave them the CPT codes 43659 and 43843 to see if they are covered. Well... they told me they are both billable codes? WTH does that mean???
All opinions are greatly appriciated

Ms_DeB
on 7/17/08 4:50 am - Waycross, GA
That's sounds like what I went through. I called my insurance co 3 times in 1 month and asked 3 different people if they paid for Obesity surgery and all 3 people all 3 times said, "YES!". My PCP referred me to the surgeon and when the surgeons office submitted me for PA the first time they denied me??!! Go figure?!

As far as your question, I'd call them back and tell them exactly what you just said that your policy says this but they say the codes are billable, sooooo what the hells up? Are they going to pay for it or not?!

Sry I ain't more help than this, Good Luck to you.......
Deanne K.
on 7/17/08 8:09 am - Tucson, AZ
Just because they are billable doesn't mean they authorized it for payment.
Mom_of_Triplets
on 7/18/08 11:26 am - AL
I'm thinking that is most likely whats going on. My understanding is the coding is pretty universal. Its whether or not those codes are authorized that differs.
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