BCBS HMO Blue Surgery Requirements - I have them here!
I can email them to you if you are interested...Here is just part of them:
Patient Selection Criteria:
The physician has indicated that the patient:
- is a well informed and motivated patient with acceptable operative risks
- a strong desire for substantial weight loss
- failure of other non-surgical approaches to long-term weight loss
- the patient is enrolled in a program which provides pre-op and post-op multi-disciplinary evaluation and care including: behavioral health, nutrition, and medical management
AND
the patient is morbidly obese (BMI > 40)
OR
The patient has a BMI >35 and the physician has indicated that the patient has one or more of the following:
- sleep apnea
- pickwickian syndrome
- pseudotumor cerebri
- obesity related cardiomyopathy
- type II diabetes
- at least stage 1 hypertension
- coronary artery disease
- obesity related pulmonary hypertension..
Hope that helps!
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