If you are considering bariatric surgery, call your insurance company to verify bariatric benefits for the treatment of morbid obesity.

Information you will need from your insurance:

1. Does your plan cover bariatric services and surgery, or is it an exclusion or only covered if life-threatening (meaning they do not cover bariatric surgery)?

• Here are the specific codes your insurance company may request:
  • ICD code of obesity E66.01
  • CPT code for sleeve 43775
  • CPT code for bypass 43644

2. If your plan covers bariatric services and surgery, you will need to know what pre-surgical requirement are necessary to qualify for surgery.

• For example, Medicaid requires six consecutive months of medical weight management and psychological evaluation.

3. What is your portion of the cost?

• Confirm how much your insurance will cover for the procedure.

In case you need to contact them again, write down who you talked to as well as a reference number for the call.

Bariatric surgery may be an option for adults with a body mass index (BMI) of 40 or more. If you have other serious health conditions, such as diabetes or heart disease, bariatric surgery may be beneficial if your BMI is between 35 and 40. If your BMI is below 35, you will not qualify for surgery.

Use the BMI calculator below to see if you qualify.

The Bariatric Surgery Program at Pascack Valley Medical Center offers several types of procedures, including:

Roux-en-Y (roo-en-wy) gastric bypass

This is the most common procedure. A surgeon creates a small pouch from the stomach and connects it directly to the small intestine. This helps lower the amount of food you can eat in one sitting.

Sleeve gastrectomy

This procedure removes about 80% of the stomach, leaving a long, tube-like pouch. This smaller stomach can't hold as much food. It also produces less of the appetite-regulating hormone ghrelin, which can curb your desire to eat.

SADI-S

Similar to a sleeve gastrectomy, this procedure also divides part of the small intestine. This surgery offers weight loss along with less hunger, more fullness, blood sugar control and diabetes improvement.

If you’d like to learn more about bariatric surgery, attending a free seminar is a great place to start. Click here to browse our seminars.

If you decide bariatric surgery is right for you, schedule a consultation by calling 877-848-9355 or visiting our Find a Doctor page.

At Pascack Valley Medical Center, we’re with you through every step of your weight loss journey and beyond. We offer comprehensive, compassionate care with modern treatment options and education and support programs that support the whole person. Our multi-disciplinary team works together to create customized plans to provide the most individualized experience possible.

The Bariatric Surgery Program at Pascack Valley Medical Center is accredited as a Comprehensive Center by the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP®), a joint Quality Program of the American College of Surgeons (ACS) and the American Society for Metabolic and Bariatric Surgery (ASMBS).