The Duke Center for Metabolic and Weight Loss Surgery asks prospective patients to take the following steps to get started.

Step 1: Investigate insurance coverage

Step 2: Register to attend a free seminar

Step 3: Apply for a surgical evaluation

Step 1: Investigate Insurance Coverage

One of the challenges for bariatric surgery patients can be gaining insurance approval for the procedure. Before you consider weight loss surgery as an option in managing your obesity, you should contact your insurance company to verify that:

• Weight loss surgery is covered by your policy
• Durham Regional Hospital and the physicians of the Private Diagnostic Clinic at Duke University Medical Center are part of your coverage

When you call your insurance company, they will want to know the codes for the operative procedures:

• Roux-en-Y gastric bypass: CPT 43644
• Gastric banding: CPT 43770
• Sleeve gastrectomy: CPT 43775
• Duodenal switch: CPT 43645
• The diagnosis code for obesity is ICD-9 278.01

To qualify for insurance coverage you must have either:

• A body mass index of greater than or equal to 40
• Body mass index between 35 and 39 and at least one major medical co-morbidity, such as:
  • Respiratory problems (sleep apnea or hypoventilation syndrome)
  • Diabetes
  • Hypertension

Using your height and weight, calculate your body mass index.

There are many different types of health insurance policies and many have strict guidelines for reimbursement for weight loss surgery.

Learn about the requirements of insurance companies that frequently cover weight loss surgery with our program

Step 2: Register to Attend a Free Seminar

Everyone who applies to the Duke Center for Metabolic and Weight Loss Surgery program starts by attending a free seminar, which we offer in Raleigh and Durham, or online. This seminar will provide you with information about obesity, surgery, and our program.

If you attend a seminar in person you should bring a support person with you. Much of the seminar is spent discussing not only potential benefits of surgery, but also possible complications and risks. We also discuss the help you may need after surgery. The more your support person knows about this operation, the more he or she can help.

Register online or call 866-637-0711 and select option two.

We feel it is very important that you know as much as you can before considering a surgical approach to the management of obesity. For that reason we have made attendance at one of these seminars mandatory for acceptance of your application for surgical consideration.

Patients who had weight loss surgery in the past and are considering revisional surgery are not required to attend the informational seminar.

Step 3: Apply for a Surgical Evaluation

Once you have attended a seminar, you can apply for a surgical evaluation. To apply, follow the link below to our secure site.

Apply now for a surgical evaluation