Part B Insider (Multispecialty) Coding Alert

Published on Mon Mar 29, 2004 PDF

While some insurers and Medicare carriers are liberalizing payment policies for bariatric surgeries, others are cutting back.
 
Marcella Bucknam, HIM coordinator at Clarkson College in Omaha, has seen a trend of payors seeing positive health effects from bariatric surgeries and loosening coverage requirements. Many Blue Cross/Blue Shield plans have taken the surgery off their list of procedures requiring prior certification, Bucknam adds.

But the Center for Studying Health System Change unveiled a new survey showing that many insurers are cutting back coverage for bariatric procedures as well as other big-ticket operations. At the same time, Blue Cross and Blue Shield of Florida said it would end bariatric coverage in 2005, calling the surgeries "risky" and "of little benefit," according to Reuters. And Nebraska's Blues plan will follow suit.

New England Journal of Medicine correspondent Dr. Robert Steinbrook told Reuters that the number of bariatric procedures grew from around 16,000 a year in the early 1990s to 103,000 last year. Singer Carnie Wilson from Wilson Philips popularized the surgery by having hers broadcast on national television.