Anyone had stomaphyx covered by insurance??

I am just wondering if anyone out there has had any luck submitting their stomaphyx surgery to insurance.  Do you have a cpt code? I have been fighting back and forth with my dr's ofc and ins. co and they have approved 3 different cpt codes yet the ofc. still says that they are not the right approval's I need. Thanks for any help!

I had my stomaphyx covered by Dr. Shawn Garber in NY.  They paid for the entire things.  He told me he gets about 75% of the procedures covered by insurance.  I have The Empire Plan.  I do not know what codes he used.

Thanks Stacy.  I emailed Dr. Garber and he confirmed that he in fact does get 80% of Stomaphyx procedures paid for by insurance!  Guess who I'm calling Tuesday morning..............!!!

Stacy which Empire plan?  I thought you had United.  Do you mean Empire BCBS or another Empire Plan?

It is the NY State EMpire plan for NY state goverment employees

I called Dr. Garber's office this morning.  The person I spoke with basically said that I need to find out on my own if my provider will pay for it.  They were not helpful at all and rushed me off the phone.  I contacted my provider (BCBS of GA) and Dr. Garber isn't even in my network, so even if they would pay for the procedure, I wouldn't qualify if I used him.  His office did say that they bill it under cpt code 43848 which I think is just revisional bariatric surgery or revisional RNY.   I researched my policy and as it's written they will only pay for a revision if you have over 40 BMI (no problem there) or less than 40 with comorbities.  Also, there has to be a REASON you're having the revision, not just because your pouch has stretched (need a fistula or staple line has come loose or something like that). 

So far it seems like only The Empire Plan is getting approved w/ Dr. Garber. My mom has this insurance and she just got approved.  Stacey said she had United, but I heard United is not covering it. I don't know. I have Empire BCBS and Stephanie from Dr. Garber's office said it is still pending with other patients that have the same insurance. By the way, as far as insurance, only speak with Stephanie from Dr. Garber's office.  I have been misinformed with policy & procedures with the other staff members.  They act like they "know it all" and know nothing; and they are not to pleasant to deal with.  Dr. Garber & Stephanie are very nice and helpful.