From Aetna's clinical policy bulletin ( http://www.aetna.com/cpb/data/CPBA0157.html )

I have cut and pasted just one small section here from the entire bulletin.

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Vertical Banded Gastroplasty (VBG) and Laparoscopic Adjustable Silicone Gastric Banding (LASGB or Lap-Band®):


Aetna considers open or laparoscopic vertical banded gastroplasty (VBG) or laparoscopic adjustable silicone gastric banding (LASGB, Lap-Band®) medically necessary for members who meet the selection criteria for obesity surgery and who are at increased risk of adverse consequences of a RYGB due to the presence of any of the following comorbid medical conditions:

1. Hepatic cirrhosis with elevated liver function tests; or
2. Inflammatory bowel disease (Crohn's disease or ulcerative colitis); or
3. Radiation enteritis; or
4. Demonstrated complications from extensive adhesions involving the intestines from prior major abdominal surgery, multiple minor surgeries, or major trauma; or
5. Poorly controlled systemic disease (American Society of Anesthesiology (ASA) Class IV) (see Appendix).

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Basically it appears that they would prefer you to get a gastric bypass because it appears to indicate that a LAP-BAND® would be approved only if you are a poor candidate for a gastric bypass.

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Dr. Ron Hekier, Texarkana LAP-BAND® Surgeon
LAP-BAND® Texarkana ( Texas | Arkansas )
Disclaimer:
All information posted by me is my personal opinion and does not reflect views sanctioned by any other body or entity. Posts on this board should not be construed to be offered as medical advice or a professional opinion.