Wrong approval code

ladylissa
on 6/16/12 9:48 am, edited 6/16/12 10:17 am - MS
VSG on 08/03/12
 Was approved for the sleeve on Tuesday so i thought, got the approval letter in the mail today and it said approved for gastric bypass WTF. I read somewhere that the codes are different and without the correct one you can be held up, so do i need to call my advocate Monday im pretty sure she received the same letter why in the hell didnt she notice. I have a appointment to meet the surgeon on the 25th to get my date should i wait until then
Moniachelle
on 6/16/12 10:08 am
VSG on 05/22/12
The gastric sleeve is VSG. or sleeve

                

                
Missy30
on 6/16/12 10:08 am
VSG on 06/27/12
I guess I am confused at what you are saying?  You got approved for the sleeve on Tue, meaning the vertical sleeve gastectomy??  And the approval letter says gastric sleeve??  I don't see the difference but there may be a difference in the insurance world with codes and stuff you probably should call your insurance company and ask them.

            

        
Jackie00
on 6/16/12 10:13 am
Vertical sleeve gastrectomy, confused as well to what or how the code is wrong.
Sleeved 15-Sept-2011 HW 294 Pre op weight 285 SW 279 GW 145?
Pre op 6 lbs lost, M1 - 23 lbs M2 - 11 lbs M3 - 12 M4 - 6 M5 -10 M6 -10 M7 -7 M8 - 4 M9 - 4
M10- 4 M11 - 5 M12 - 0
   

   
ladylissa
on 6/16/12 10:16 am - MS
VSG on 08/03/12
 Im sorry im so upset it said gastric bypass
Missy30
on 6/16/12 10:25 am
VSG on 06/27/12

Ok i see now.  If you don't have a surgery date yet I would think that is something that can be changed pretty quickly depending on what insurance you have.  I have bcbs of tx and before I even got a surgery date the surgery center sent in a fake date the lady called it and I was approved for that date then when I scheduled with them that date I could do June 27th the re sent for the new date.  Just got my letter the end of last week saying approved for the sleeve June 27th.  Im thinking you can get it taken care of without issues.  Sorry you are going through this.

            

        
Jaffe
on 6/16/12 10:24 am - PA
VSG on 03/19/12
 Insurance codes are as follows:

Laproscopic Sleeve Gastrectomy  43775
Laproscopic Adjustable Band  43770
Laproscopic Gastric Bypass  43644

Call the number on your insurance card and make sure your plan covers the sleeve code.

  HT:  5' 7"    HW:  249   ConsultW:  238   SW:  218   Preop Loss:  20
  M1:12  2:11  3:7  4:7  5:8  6:8  7:7  8:3  9:0  10:3  11:3  12:4  13:0  14:4  15:
       

natalie37
on 6/16/12 10:29 am - Advance, NC
Revision on 03/28/12
I agree- YOU call your insurance company and ask- document everything- get names of who you talk to etc. then call the surgeon's office and relay what you found out and demand they call to and get it worked out. keep bugging them until it's resolved!!
Natalie
ladylissa
on 6/16/12 10:32 am - MS
VSG on 08/03/12
 Im with Cigna (OAP) and they do cover the sleeve. I just dont understaand how someone that does this everyday can make this kind of mistake.
happymom80
on 6/16/12 2:34 pm - MO
VSG on 03/05/12
 I'm with Cigna too...like I said, happened to me...they were very good about changing it. I never called Cigna about it, I just called my dr. office. It is probably a mistake on their end in the billing. If it is like my dr. office, they do more RNY than VSG and it is easy to check the wrong box. Still...not the best in customer service...but it will work out just fine! Promise! :)

HW: 350+ (I didn't look after that)  SW: 328  

    

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