Blue Cross Blue Shield Texas Bariatric Surgery Requirements

August 27, 2022

Blue Cross Blue Shield Texas Bariatric Surgery Requirements

For more information about the Blue Distinction Centers for Bariatric Surgery please visit the Blue Cross and Blue Shield Association website. Use PCP HMO online request tool.

Blue Cross Requirements For Weight Loss Surgery Obesity Reporter

They are often used as guidelines for coverage determinations in health care benefit programs.

Blue cross blue shield texas bariatric surgery requirements. Blue Cross Blue Shield of Texas Criteria for Insurance Coverage. Since the initial surgery Weight loss is less than 50 of initial procedure pre-operative excess body weight. Bariatric surgery is recommended only under limited circumstances in individuals in the later stages of development Tanner pubertal development stages 4 or 5 and final or near final adult height with a BMI of greater than 40 kgm 2 and mild co-morbidities or greater than 35 kgm 2 and major co-morbidities.

Telligent is an operating division of Verint Americas Inc an independent company that provides and hosts an online community platform for blogging and access to social media for Blue Cross and Blue Shield of Texas. Weight remains at least 30 over ideal body weight using standard tables for adult ranges from the National. The precertification requirements lists in this document are intended as a general summary only and are subject to change without notice.

Blue Cross Blue Shield Association is an association of independent Blue Cross and Blue Shield companies. Blue Cross Blue Shield of Massachusets covers 4 weight loss procedures including the Gastric Sleeve Gastric Bypass and Duodenal Switch assuming your policy includes bariatric surgery. To view this file you may need to install a PDF reader program.

In order to be approved by Blue Cross Blue Shield Texas for bariatric surgery in the United States you must meet the following criteria. For bariatric surgery use the BCBS Blue Distinction Facility Search. A Body Mass Index BMI greater than 40.

Letter from primary care physician. However all requests for bariatric surgery require authorization by BCN. You must undergo one of the covered bariatric surgical procedures at a Blue Distinction Center for Bariatric Surgery.

Vertical-banded gastroplasty may be performed using an open or laparoscopic approach. The patient has to be at least 16 years old at the time of applying for coverage. Blue Distinction Centers BDC met overall quality measures for patient safety and outcomes developed with input from the medical community.

Type 2 Diabetes or. An Independent Licensee of the Blue Cross and Blue Shield Association Bariatric Surgery requiring reoperation. 18 years old or older.

Blue Distinction Centers for Bariatric Surgery. You need to be at a documented. A Local Blue Plan may require additional.

Be age 18 years or older. File is in portable document format PDF. Body Mass Index equal to or greater than 35 with at least two of the following comorbidities.

Blue Cross Blue Shield Association an association of independent Blue Cross and Blue Shield Companies. Diagnosis of Morbid obesity defined as. This page explains the coverage requirements plan.

40 Body Mass Index BMI 35 BMI with two conditions. Blue Distinction Centers and Blue Distinction Centers for Bariatric Surgery offer a full range of bariatric surgery care including. The Body Mass Index BMI of the patient should be over 40.

In case there is no endorsement the patient will not be considered for weight loss surgery coverage. In order to be pre-approved for the procedure you must meet the following requirements. You need must be between the ages of 18 and 60 years old Exceptions to the age requirement can be made for patients under 18 years old if a letter is provided to the carrier by.

BMI 35 399 AND one of the following. Weight loss surgeons consult and recommendation. Blue Cross and Blue Shield of Texas BCBSTX Medical Policies are based on scientific and medical research.

Dilation of the stoma is a common reason for weight regain. BCN members are not required to have their bariatric surgery performed at a Blue Distinction Center. You must have at least one other condition considered a co-morbidity uncontrolled at maximum medical management and which is generally expected to be reversed or improved by bariatric treatment to include but not limited to.

To be approved for the weight loss surgery you must meet the minimum requirements. Active partaking and certification of non-surgical weight loss techniques. BMI 35 399 AND one of the following.

These centers have lower complication rates and fewer readmissions. This basically means that the individual policy contains coverage. This recommendation is categorized as a weak.

View Medical Policies. Diagnosis of Morbid obesity defined as. In order to be approved by Blue Cross Blue Shield of Arizona for bariatric surgery in the United States you must meet the following criteria.

Body Mass Index equal to or greater than 40. A Body Mass Index BMI greater than 40. 3 Blue Distinction Centers for Bariatric Surgery Program Selection Criteria Cost Nationally consistent and objective approach for selecting BDC was used to address market and consumer demand for cost savings and affordable healthcare.

Texoma Medical Center Recognized With Blue Distinction Center Designation For Quality And Cost Efficiency In Bariatric Surgery Texoma Medical Center