BCBS Federal Anyone?

I selected the DS over RNY for a few reasons. The main reason is that I have CVID which gives me a high chance of stomach cancer in addition to a family history of stomach cancer. This requires me to get regular EGDs. If i had the RNY my stomach would be hidden and inaccessible.

The other reason was after alot of research it looks like the RNY isn't very malabsorptive. Which I know I need.

The diagnosis code for obesity? I went to the doctor on Monday to start my 3 months weight tracking.

I just checked the labs paperwork, he did use E66.01 which is the ICD10 for the condition.

Yes, that is the correct code. It's missing from my codes so I lost a month on my tracking. Not too happy about that but nothing I can do. Dr. said it's fraudulent to add codes after the visit.

That is actually incorrect. I'm a medical coder so I know quite a bit about codes and documentation rules. When it comes to coding the rule is "If it's not documented, it's not done". If the dx was documented as obesity, you can have the code added. If the the doctor never documented you as having obesity then you have the legal right to request an addendum (That's when the Dr adds to his note to clarify). Also, if your height/weight/and BMI were documented, then the code for obesity can be coded.

I would highly encourage u to get your Dr notes and see if it was the Dr or coder mistake. If you'd like I can look at them. Either way you can most definitely get that changed.

The office manager at the Dr's office refuses to have it added, believe me, I have tried. She talked to the dr, he said that my weight was not the "reason" for the visit, therefore, they will not add the code.

If you weren't there for weight management, then what was it for?

Regular MD visit, follow up on BP meds. General DR visits not specifically about WL. Not my surgeons office, I am talking about my regular MD's office.

Ok I see, yeah that wouldn't qualify. Dr can't document what wasn't discussed. Those 3 visits will fly by and before u know it you will have your surgery :)

I am not understanding what we are supposed to be doing during this 3 months? Are we supposed to be losing weight? I have e-mailed my Dr office but they haven't gotten back to me yet. If my BMI drops below 35, will the approval be declined? Did your dr explain this better? thanks!