"We will continue to work with the medical community and coverage providers to improve access to bariatric and metabolic surgery so that we can more effectively meet the needs of patients," said Robin Blackstone, MD, FACS, Chairman of Access to Care Committee, ASMBS. "We hope other insurers will follow the lead of Aetna and United Healthcare and expand coverage to include sleeve gastrectomy as a medically necessary treatment option."

Dr. Blackstone says the ASMBS will continue working to improve access to care for bariatric and metabolic surgical procedures that eliminate, resolve or improve obesity-related diseases like the remission of Type 2 diabetes, hypertension and sleep apnea.

Last year, the ASMBS joined with the Society for Alimentary Gastrointestinal and Endoscopic Surgery (SAGES) to request a procedure code from the American Medical Association (AMA). The requested was granted and a code (CPT 43775) was established for use on January 1, 2010. Procedure codes are used by insurers to identify surgical, medical or diagnostic services and to determine coverage and reimbursement.

Bariatric surgery is indicated for adults who have a body mass index (BMI) of 40 or higher or have a BMI of 35 accompanied by an obesity-related condition such as Type 2 diabetes or hypertension.

SOURCE American Society for Metabolic & Bariatric Surgery (ASMBS)

www.asmbs