Highmark bcbs bariatric surgery policy

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August undefined, 2024

WebPlease fax completed form to the Medical Management and Policy Department: 888.236.6321 or 800.670.4862 (Delaware Only) Provider Information Patient/ Procedure … WebBariatric surgery should be performed in appropriately selected patients by surgeons who are adequately trained and experienced in the specific techniques used and in …

Medical Policy Bulletin - Highmark

WebThe following CPT code is considered investigational for Commercial Members: Managed Care (HMO and POS), PPO and Indemnity: Procedure codes: 43847Gastric restrictive procedure, with gastric bypass for morbid obesity; with small intestine reconstruction to limit absorption 43645 Laparoscopy, surgical, gastric restrictive procedure; with gastric … WebJun 12, 2024 · Surgery Date: 04/01/2024. Height: 5 feet 2 inches. Starting Weight: 277 lbs. Weight Lost: 118 lbs. Current Weight: 159 lbs. Goal Weight: 140 lbs. BMI: 29. Posted April 27, 2024. My dr office didn't know that Highmark changed their policy about the six month wait, so four months in I found out about the change thanks to this forum! marybeth sharpe

Summary of Benefits and Coverage: What this Plan …

WebMedical Policies The policies contained in the FEP Medical Policy Manual are developed to assist in administering contractual benefits and do not constitute medical advice. They are not intended to replace or substitute for the independent medical judgment of a practitioner or other health care professional in the treatment of an individual member. WebPOLICY STATEMENT Highmark Health Options may provide coverage under the medical-surgical benefits of the ompany’s Medicaid products for medically necessary bariatric … WebImportant Legal Information:: Highmark Blue Cross Blue Shield, Highmark Choice Company, Highmark Health Insurance Company, Highmark Coverage Advantage, Highmark Benefits Group, Highmark Senior Health Company, First Priority Health and/or First Priority Life provide health benefits and/or health benefit administration in the 29 counties of ... huntsman\\u0027s-cup j4

Blue Distinction Specialty Care Blue Cross Blue Shield

WebPolicies are written to cover a given condition for the majority of people. Each individual's unique clinical circumstances may be considered in light of current scientific literature. Medical policies are based on constantly changing medical science and Blue Cross reserves the right to review and update our policies as necessary. Medical Policies. WebELLIS BARIATRIC CARE CENTER - MAIN is a medical group practice located in Schenectady, NY that specializes in Dietetics and Nursing (Registered Nurse). Providers Overview Location Reviews Providers marybeth sharkeyWebHome page ... Live Chat huntsman\\u0027s-cup jh

"WebBariatric Surgery Precertification Worksheet PROVIDER INFORMATION PATIENT/PROCEDURE INFORMATION Please answer all questions below: ... Highmark Blue Shield is an Independent Licensee of the Blue Cross and Blue Shield Association. Created Date: 9/10/2024 9:52:17 AM ... " - Highmark bcbs bariatric surgery policy

Highmark bcbs bariatric surgery policy

Web1 This facility indicated voluntarily that Radiologists, Anesthesiologists, Pathologists, Hospitalists, and Intensivists who provide services for elective (scheduled) procedures related to this Blue Distinction Specialty Care program are in the local Plan's BlueCard PPO network. 2 This is a freestanding surgery center that performs outpatient ... Weban Independent Licensee of the Blue Cross and Blue Shield Association If a conflict arises between a linical Payment and oding Policy ( ^ P P _) and any plan document under which a ... ^Repair of a hiatal hernia at the time of bariatric surgery that is diagnosed at the time of bariatric surgery, or ... Medical Policy: Bariatric Surgery, SUR716 ...

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WebJan 1, 2024 · Highmark Blue Cross Blue Shield: my Direct Blue EPO Gold 0 Coverage for: Individual/Family Plan Type: EPO The Summary of Benefits and Coverage (SBC) … WebTo view the out-of-area Blue Plan's medical policy or general pre-certification/pre-authorization information, please enter the first three letters of the member's identification number on the Blue Cross Blue Shield ID card, and select the type of information requested. Type of Information Being Requested

WebMedical Policies A-Z. Medical policies serve as one set of guidelines for determining what medical services, procedures, devices and drugs may be eligible for coverage. View the medical and drug authorization tables to determine when to request an authorization. InterQual® criteria is used to evaluate whether a medical procedure or equipment ... WebHighmark's mission is to be the leading health and wellness company in the communities we serve. Our vision is to ensure that all members of the community have access to affordable

WebApr 28, 2014 · The eligible bariatric surgical procedures listed above unless otherwise specified are covered for members under the age of 18 years when they meet all of the … WebRevision surgery to address perioperative or late complications of a bariatric procedure is considered medically necessary. These include, but are not limited to: Staple-line failure. Obstruction. Stricture. Non-absorption resulting in hypoglycemia or malnutrition, weight loss of 20% or more below ideal body weight.

WebOct 28, 2013 · NOTE: The patient must be at least 18 months postoperative following bariatric surgery. NOTE: Report procedure code 15830 (Excision, excessive skin and subcutaneous tissue [includes lipectomy]; abdomen, infraumbilical panniculectomy) when performing a panniculectomy.

WebAug 24, 2024 · Bariatric surgery should be performed in appropriately selected individuals by surgeons who are adequately trained and experienced in the specific techniques used and in institutions that support a comprehensive bariatric surgery program, including long … Highmark retains the right to review and revise its medical policy guidelines at its … Input your Medical Policy search words... This site works best if viewed with the … If you have specific questions or comments related to medical policy content, please … These terms and conditions are applicable to Campaign Texts and Member Texts. … marybeth shamrock kpmghttp://highmarkblueshield.com/ mary beth shamelWebHighmark Blue Shield: my Blue Access PPO Bronze 3800 Coverage for: Individual/Family Plan Type: PPO The Summary of Benefits and Coverage (SBC) document will help you … huntsman\u0027s-cup j2WebCoverage Details Coverage Details Detailed below, you will find the most current Summary of Benefits for each plan. Reviewing a plan’s SBC may make it easier to understand its benefits and coverage. It is a summary designed to help you compare plans. Please review the SBC for the month that you’d like your plan to start. huntsman\u0027s-cup jcWebJul 15, 2024 · June 2024 Highmark BCBS Medical Policy Updates: Arthrocentesis or Needling of Bursa. Assistant Surgery Eligibility Criteria. Assisted Reproductive Technology. Autism Spectrum Disorders. Belimumab (Benlysta) Bevacizumab (Avastin) and Bevacizumab Biosimilars. Braces and Supports. mary beth sharpWebSep 17, 2024 · Bariatric surgery should be performed in appropriately selected individuals by surgeons who are adequately trained and experienced in the specific techniques used and … marybeth shawWebMedical Policy Highmark Health Options is an independent licensee of the Blue Cross Blue Shield Association, 1 an association of independent Blue Cross Blue Shield Plans. … mary beth shaw facebook