Unbiased Muscle Building

The lap band System has been around since 1994, and over 350,000 have been implanted worldwide. The LAP-BAND System was FDA approved in the U.S. in 2001, and has since rapidly become one of the most popular options for weight loss surgery. LAP-BAND Surgery has been clinically proven as an effective and safe weight loss procedure. Adjustable gastric banding is estimated to be the number one type of weight loss surgery in the U.S. by 2010. Awareness of the LAP-BAND System has increased greatly over the past two years due to the consumer and physician awareness programs of Allergan.

Unlike the gastric bypass surgery, the LAP-BAND System procedure does not require stomach cutting or stapling or gastrointestinal rerouting to bypass normal digestion. The LAP-BAND System is 10 times safer and has 1/10 the serious complications of gastric bypass. LAP-BAND System procedure is frequently done as an outpatient procedure, with a quicker return to normal activity than the gastric bypass. LAP-BAND System is reversible and adjustable. Weight loss at three years is very comparable for both procedures.

The LAP-BAND System can help adults, at least 18 years old, who are 100 pounds over their ideal body weight or have a Body Mass Index (BMI) of 40 or greater. People with a BMI of 35 or greater with weight-related health problems may also be eligible for the LAP-BAND System. Criteria vary by state and payer. A patient who meets the criteria above may not necessarily meet the criteria required by their insurance provider. Ultimately, it is the surgeon’s decision as to who qualifies for surgery. Your best option is to check with your surgeon and ensure that you are clear on his or her selection criteria. Outpatient settings (surgery centers) will typically have additional criteria related to patient selection, for example an upper BMI limit, and restrictions related to the general, respiratory and cardiac health of the patient. The patient should demonstrate a commitment to lifestyle change, and an ability to understand the procedure and what is required of them.

Most major insurance providers, including Medicare, cover the LAP-BAND System for patients that meet the standards set by the FDA. Coverage varies by payer, and is also dependent upon your employer’s specific insurance policy. If possible, offer to verify the patient’s coverage for them. Allergan has a reimbursement hotline that is available to assist you with this process. Be aware of the requirements of the primary payers in your area, as well as the time it typically takes for you to get a patient approved and into surgery. Many payers require a patient to undergo medically supervised weight loss prior to surgery (typically for six months), and this process can significantly delay the process. Many insurance denials are appealable, and Allergan’s Reimbursement Hotline is available to assist you with this process. If a patient’s policy has a specific exclusion for bariatric surgery coverage, their best option is to contact their Human Resources Department. However, they will likely have to pay cash if they wish to have the procedure performed. This is an opportunity to discuss the option of paying cash for the procedure and whatever financing programs you have available.

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