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"Dental necessity" or "dentally necessary" means or describes a dental service that a dental care provider, exercising prudent clinical judgment, would provide to a covered person for the purpose of evaluating, diagnosing or treating a dental illness . *GP( @ r UQ T9 Blue Cross Blue Shield of Minnesota Medical Policy *GP( @ r UQ T9 *GP( @ r UQ T9 Bariatric surgery in patients with diabetes and body mass index less than 35 kg/m 2. The eligible bariatric surgical procedures listed above unless otherwise specified are covered for individuals under the age of 18 years when they meetALLof the following criteria: If the adolescent does not meetALLof the adolescent selection criteria for bariatric surgery, the procedure will be denied as not medically necessary. ; This also applies to the Blue Care Network of Michigan. However, the following documentation must be submitted: Blue Cross Michigan has strict guidelines for the requirement of a Center of Excellence. Goal Weight: 149 lbs. 1 0 obj
This Program aligns with the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Blue Cross and Blue Shield of Illinois, aDivision of Health Care Service Corporation, a Mutual Legal Reserve Company, an Independent Licensee of the Blue Cross and Blue Shield Association, PDF File is in portable document format (PDF). Provider Resource Center - BCBSWNY *GP( @ r UQ T9 773 0 obj
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*GP( @ r UQ T9 For further inquiries, contact Blue Cross Blue Shield of Louisiana HMO through their official website https://www.bcbsla.com or call them using the numbers behind your ID card (1-800-495-2583) to get accurate costs on various medical procedures they might be providing cover for based on price and location. 13 0 obj
Surgeon: James Stephen Scott. The items below are the minimum necessary for approval of your weight loss surgery. Typically, Blue Cross Blue Shield does offer coverage if your primary procedure does not produce the expected results. Anthem BCBS - Requirements for Weight Loss Surgery rvYWDgg!MxV Rohit A Patel, MD, FACS, FASMBS | Cooper University Health Care Blue Distinction Centers and Blue Distinction Centers+ for Bariatric Surgery offer a full range of bariatric surgery care, including: These centers have lower complication rates and fewer readmissions. *GP( @ r UQ T9 Open and laparoscopic vertical banded Gastroplasty, Patients compliance with post-operative diet and exercise regimen. Weight loss surgery is an effective treatment for morbid obesity. Bariatric Surgery Bariatric surgery is performed to treat morbid (clinically severe) obesity. 18 - FEP Blue Focus Sometimes you will need to Read more This policy version was replaced October 31, 2022. . Obesity is an increase in body weight beyond the limitation of skeletal and physical requirements, as a result of excessive accumulation of fat in the body. 6/2022 . TTY users can call 1-877-486-2048. You can also locate a contact number and email address on their website after choosing your state. If you are a Highmark member, please review and discuss any questions regarding medical policies with your treating provider and refer to your specific .