An amazing thing happened over the last few years. More and more surgeons have presented data that showed that gastric sleeves (Sleeve Gastrectomies) are an effective primary surgical procedure for weight loss.
And surprisingly one of the major insurance carriers agreed! United Healthcare should be applauded for listening to the experts in the field of bariatric medicine rather than waiting for others to move first.
On January 1st, 2010 they added this procedure to their policies that cover weight loss surgery.
Gastric Sleeve Surgery
The gastric sleeve procedure was originally used as the first stage in gastric bypass or duodenal switch patient for very obese patients.
A surgeon would evaluate their patients and if they were morbidly obese with other risk factors, often they would spread out a primary weight loss surgery over two procedures.
This did two important things.
- It made the amount of time under anesthesia shorter.
- It allowed the patient to lose some initial weight and reduce the overall risk of the procedure.
Surgeons found that after the first stage, the gastric sleeve, their patients often lost enough weight and did not need a second procedure.
More and more data started to surface and surgeons started to offer this procedure to their patients as a primary treatment for morbid obesity.
Patients liked the gastric sleeve option because it was easier than a gastric bypass, produced similar results, and they did not have to come back for fills as they would have to do with a gastric band (Allergan’s Lap Band or Johnson and Johnson’s Realize Band).
Insurance and Sleeve Surgery
The only drawback with gastric sleeve surgery has been that it was previously not covered by insurance. Expected weight loss from gastric sleeve surgery is between gastric band surgery and gastric bypass surgery.
In the insurance industry there are usually two ways a new procedure is added for coverage.
- It’s a revolutionary new procedure that has data to support its efficacy and one private insurance company makes the first move to provide coverage.
- Political pressure.
For instance, some states have required private insurance companies to provide coverage for weight loss surgery.
We’re happy to announce that the new CPT (billing code) for gastric sleeve procedures is 43846 and we hope that your insurance company will cover gastric sleeve surgery soon.