CPT code or name of procedure

Does anyone know if the insurance company when doing precertification and response to appeals goes by the CPT code or the procedure name? See when I just randomly call my insurance company and ask if the CPT code for duodenal switch that my doctor uses is covered they say yes as long as I meet the requirements (normal WLS requirements) but they won't provide that in writing for me (EVIL). But then I've been denied once for experimental and when I talked today with the lady that is handling my appeal she mentioned that she sees the name of the procedure being listed as experimental. I'm thinking that they should be going off the CPT code because that's how they will ultimately be paying for the procedure right? I'm just confused! Thanks in advance for any assistance! Elizabeth Revis Pre-Op Dr Gonzales 270 BMI 55

The answer to your question is BOTH. When the CPT code is entered into the computer, the name of the procedure is automatically filled in. You won't get approved by omission of the name.