Here’s the checklist I put together so you could see the things I had to do for the surgeon who was going to perform my Lap-Band Surgery as well as for the insurance company; to meet their requirements. Please note: various surgeons and insurance companies may have different requirements.
LAP-BAND CHECKLIST
I had Blue Cross Blue Shield of Michigan insurance when I had this surgery done.
- Complete day long seminar at surgeon’s office; receive informational packet
- Complete an “Insurance Worksheet”
- Complete “Release of Information Form”
- Complete “Medical History Form”
- Complete “Questionnaire”
- Complete a Psychological Evaluation
- Primary care physician (PCP) completes the following on you:
- Pulmonary Function Test; get clearance
- A full lab work up to establish current levels
- Cardiac clearance to undergo bariatric surgery
- Upper endoscopy
- EKG
- Chest X-ray
- You will need your primary care physician to write a letter giving his/her support for you to have the surgery and also to list out your comorbidities.
- Needs to give you “medical clearance” as well.
- 12 months of diet documentation (Weight Watchers logs, etc.) or whatever your insurance company requires
DUODENAL SWITCH (DS) CHECKLIST
Different surgeons may have different requirements. This is what was required of me by my DS surgeon. I had Aetna insurance when I had this surgery done.
- Psychological evaluation
- Bone density test
- Fasting blood work
- Chest X-ray
- EKG (had done at primary care physician’s office)
- A letter from PCP regarding all medical conditions, weight loss and expressing his/her support of your decision to get WLS ( I have the letter I wrote up myself and took to my PCP to get him to sign it. It is part of my free guide; you may receive this information by signing up with your e-mail address on the main page). P.S. I do not resell your e-mails or spam you.
- $1000 program fee – had to be paid 1 week before surgery & insurance does not cover it. It was out of pocket (it used to be $5000 but due to current economic climate I guess they decided to lower it. Yay, for me!)
- Check with your insurance company to ensure the surgery is a covered benefit and that the hospital is in network. The procedure code I was given is: 43847, diagnosis code 27801 if you’d like to ask ahead of time.
Also, please note, if you are revising from a Lap-band to the DS, you should un-fill your band a few weeks before surgery to give your tummy time to rest. I emptied mine 4 weeks before hand. Also, please remember to stop taking birth control pills 4 weeks before surgery. I actually stopped taking mine and instead had the Mirena placed.
