Transforming the Revenue Cycle
for Bariatric Practices

Delivering end-to-end billing and coding services

Bariatric procedures play a pivotal role in helping individuals achieve significant weight loss and improve their overall health. The intricate nature of bariatric treatments demands specialized billing and coding services to ensure healthcare providers receive accurate and timely reimbursements for their essential services. At MBW, we understand the unique challenges of bariatric billing and have developed tailored solutions to streamline the process and enhance financial outcomes for your practice.

Our Experience in the Bariatric Revenue Cycle

Our team of certified coders and billers has experience working with several bariatric practices. We recognize the complexities involved in coding for weight loss surgeries and related treatments, and our expertise covers a range of coding systems, including ICD-10, CPT, and HCPCS. With certifications from reputable organizations and a commitment to staying abreast of industry changes, our team ensures that your bariatric billing is handled with precision and compliance.

Bariatric Surgery Services

Key Areas of Expertise:

  1. Procedure Coding: Accurate assignment of codes for various bariatric procedures, ensuring compliance with industry standards.

  2. Insurance Verification: Thorough verification of patient insurance coverage to minimize claim denials and delays.

  3. Preauthorization Assistance: Facilitating the preauthorization process to ensure smooth approval for bariatric surgeries.

  4. Patient Education: Billing services that encompass patient education, an essential component in bariatric care.

  5. Postoperative Care Billing: Comprehensive billing for postoperative care and follow-up services

Best Practices for Bariatric Billing

We adhere to the highest standards of compliant coding and billing in the bariatric field, employing best practices to optimize your financial processes:

  • Patient Education and Pre-authorization:

    • Educate patients on insurance coverage, costs, and financial responsibilities.

    • Verify insurance benefits and obtain pre-authorization to prevent claim denials.

  • Accurate Documentation:

    • Ensure precise records, including medical necessity and BMI details.

  • Coding Compliance:

    • Stay current with CPT and ICD coding guidelines.

    • Accurately code procedures reflecting complexity and specifics.

  • Charge Capture:

    • Implement effective processes to avoid missed charges.

    • Regularly review and align charges with services provided.

  • Timely and Accurate Billing:

    • Submit claims promptly to minimize reimbursement delays.

    • Utilize electronic billing systems to reduce errors.

  • Denial Management:

    • Establish a robust process to promptly identify and address denials.

    • Analyze denial patterns and implement corrective actions.

FAQs for Bariatric Surgery Billing Services

Bariatric surgery billing services handle the unique coding, insurance, and claim requirements for weight-loss procedures. They ensure accurate submissions and reduce denials, helping providers maximize revenue and stay compliant.

Common CPT codes include:
- 43644: Laparoscopic gastric bypass
- 43775: Sleeve gastrectomy
- 43770: Adjustable gastric banding
Use the latest CPT codebook or consult billing professionals for updates.

Many insurance plans do cover bariatric surgery, but require documentation of medical necessity, pre-authorization, and a history of weight-loss attempts. Coverage depends on the insurer and the patient’s policy.

Billing services contact insurance providers to verify patient eligibility, benefits, and prior authorization requirements. They compile medical documentation and submit preauth requests to avoid delays or denials.

Yes. Many practices offer payment plans or financing options to cover out-of-pocket costs not covered by insurance. Billing services can help communicate these options clearly to patients.

Frequent causes include missing preauthorization, insufficient documentation, incorrect CPT or ICD-10 codes, and billing bundled services separately. Expert billing teams help prevent and resolve these issues.

They ensure that follow-up visits, labs, and complications are billed correctly under global periods or separate codes as appropriate. Timely submission and accurate documentation are essential.

Steps include verifying benefits upfront, obtaining preauths, submitting clean claims, following up on unpaid claims, and managing denials proactively. Outsourced billing teams often streamline these tasks.

They stay updated with CMS guidelines, CPT/ICD changes, and payer-specific rules. Certified coders, internal audits, and training ensure adherence to regulations and reduce audit risks.

Specialists understand the nuances of bariatric procedures, ensure coding accuracy, reduce denials, and free up clinical staff to focus on patient care—ultimately increasing practice revenue and efficiency.