Please help with Letter of Medical Necessity
Please, some kind soul help - I'm using the model Letter of Medical Necessity on Obesityhelp.com., but need three questions answered: 1) The initial paragraph talks about personal BMI, and for me would go like this: I am 5 ft. 6 1/2 inches tall and I weigh 350 pounds. My body mass index is 56.5." It goes on to explain how a BMI is calculated, talks about the numbers that indicate mild, moderate, severe, and very severe obesity (BMI greater than 40). The final statement is "The annual number of deaths in America attributable to obesity has been estimated to be 300,000 deaths per year. With my abnormally high BMI, I am at an estimated ____percent increased rish of death at my present weight." I need the blank filled in. Obesityhelp.com is so wonderful and all-inclusive, I'm sure the way to calculate this is right in front of me, but I sure can't find it. Also, the model Letter refers to the Diagnosis Code for Gastric Bypass as 278.01, and the Prodcedure Code as being 43844. Is that for LAP, as well as open procedure, or are they two different Procedure Codes and Diagnosis Codes? And finally, do I need to specify a surgeon's name in my request to the insurance co., for approval. And, yes, I do have to do all this leg work myself; this approval business takes long enough, and I've heard too many horror stories about things being "lost, mis-faxed, not faxed at all, sitting on someone's desk for weeks," etc. When I finally submit my stuff, it may be in a bound book, so I can't hear any more excuses than many of us to, as it is, when parties are trying to deny individuals this surgery.
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