Bariatric surgery diet plans
This physician-supervised nutrition and exercise program must meet all of the following criteria. Physician-supervised nutrition and exercise program: Member has participated in physician-supervised nutrition and exercise program (including dietician consultation, low calorie diet, increased physical activity, and behavioral modification), documented in the medical record at each visit. e. Some Aetna plans entirely exclude coverage of surgical treatment of obesity. , person meets the criteria for treatment of obstructive sleep apnea set forth in. Roux-en-Y Gastric Bypass (RYGB), Laparoscopic Adjustable Silicone Gastric Banding (LASGB), Sleeve Gastrectomy, Biliopancreatic Diversion (BPD) and Duodenal Switch (DS) Procedures. Note: Most Aetna HMO and QPOS plans exclude coverage of surgical operations, procedures or treatment of obesity unless approved by Aetna.
BMI exceeding 40 with one or more of the following serious co-morbidities. For adults aged 18 years or older, presence of persistent severe obesity, documented in contemporaneous clinical records, defined as any of the following. BMI exceeding 50 with one or more of the following less serious co-morbidities. BMI greater than 35 in conjunction with any of the following severe co-morbidities. Clinically significant obstructive sleep apnea (i. Aetna considers open or laparoscopic short or long-limb Roux-en-Y gastric bypass (RYGB), open or laparoscopic sleeve gastrectomy, open or laparoscopic biliopancreatic diversion (BPD) with or without duodenal switch (DS), or laparoscopic adjustable silicone gastric banding (LASGB) medically necessary when the selection criteria listed below are met. The nutrition and exercise program may be administered as part of the surgical preparative regimen, and participation in the nutrition and exercise program may be supervised by the surgeon who will perform the surgery or by some other physician.
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