Steps to Weight Loss Surgery

We have created a video for you to review to determine if the MUSC Health Metabolic & Bariatric Surgery Program is a good fit for you.

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Are You a Candidate for Weight Loss Surgery?

Criteria for qualifying for weight loss surgery typically centers around calculating how much excess weight you are carrying or your current Body Mass Index (BMI). This criteria can include the following:

• You are more than 100 pounds over your ideal body weight
• You have a BMI of over 40 kg/m2
• You have a BMI of over 35 kg/m2 and are experiencing severe negative health effects, such as high blood pressure or diabetes, related to being severely overweight
• You are unable to achieve a healthy body weight for a sustained period of time, even with medically-supervised dieting
  

Steps to Weight Loss Surgery

View our Steps to Weight Loss Surgery for our program-specific protocol for appointments with our interdisciplinary team of specialists including surgical evaluation, nutritional evaluation, psychosocial evaluation, and lab work

Other Requirements

• After surgery, patients should be able to commit to frequent clinic visits, classes/support groups and behavior change for optimal success.
• Patients must be aware of and accept the risks associated with surgery and dramatic weight loss.
• While you may be an ideal candidate for bariatric surgery, your decision may depend on insurance coverage. We strongly recommend contacting your insurance company to determine if you have coverage for bariatric surgery before starting the process. It can be disappointing to get started only to find out your insurance company will not cover surgery. We do have self-pay options available if that is an option for you.

Non-Surgical Programs at MUSC

MUSC Health Weight Management Center provides a number of non-surgical programs to help patients lose weight if you decide against bariatric surgery, or if you determine that you do not have insurance coverage and self-pay is not an option for you.

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Verify that weight loss surgery is a 'covered benefit' and is not a plan exclusion.

Ask your insurance company if the following procedures are covered at MUSC Health by your insurance plan:

• Sleeve Gastrectomy (CPT 43775)
• Roux-en-Y Gastric Bypass (CPT 43644)
• SADI (CPT 43659 or 43845)
• Biliopancreatic Diversion with Duodenal Switch (CPT 43845)
• Lap Band Removal (CPT 43774)

Ask about criteria that may be required by the insurance company for surgery approval:

• View a list of questions (PDF) to ask when you call to help determine your benefits
• ‘Medically supervised’ weight loss attempts are often required by insurance companies
• Ask how many months are required (3 to 6 months are typical)

Our educational Patient Guide (PDF) is a quick overview for you to learn more about surgical weight loss options, shared decision-making, surgery risks and benefits, and each procedure's unique features.

When you are ready to proceed, please complete the patient information forms (PDF), including a medical and nutritional history questionnaire and a copy of your insurance card (front and back). Return the completed forms to us by mail, fax, or email:

Mail: MUSC Health Bariatric Surgery Program
Ashley River Tower
25 Courtenay Drive, MSC 290
Charleston SC, 29425

Fax: 843-876-4201

Email: wls@musc.edu

When we receive your completed patient information forms, you will be contacted by our New Patient Coordinator to schedule your initial consultation to meet with the surgeon and team.

You should begin working on your insurance requirements, such as monthly visits with your primary care provider if required by insurance.

Your initial consultation will be with the bariatric surgeon, registered dietitian, and nurse coordinator to discuss your options and candidacy for surgery.

You will have labwork drawn after you meet with the clinicians. Recommendations to start vitamins for all patients, plus any additional vitamins for deficiency, will be sent following your visit. You can see lab values, letters from the dietitians, and communicate with questions using MyChart, the electronic medical record.

Location: GI Surgery Clinic
Ashley River Tower,
25 Courtenay Drive,
Charleston SC, 29425

Parking is available in the McClennan Banks Street Garage, or you can valet.

We have a no-show policy: If you fail to show up or cancel within 24 hours your initial patient appointment with the bariatric team 3 times, you will be dismissed from the program for 12 months. Please make every effort to show up or call before 24 hours if you are going to miss an appointment.

Your consultation will be initiated by the bariatric social worker.

All patients must attend our Preoperative Education class to learn about their new post-op lifestyle and medical and nutritional guidelines after bariatric surgery. The team will discuss this with you at your initial consultation.

Please complete the virtual class through your BariTrax account. BariTrax is our online patient portal where you can watch the video, take a quiz, and download the booklet.

Don't forget to take the quiz after you watch the videos. This is a 24-question quiz, and you must score an 80% to fulfill the pre-op class requirement. If you have questions, please contact Alyshia Clark at wls@musc.edu to discuss the pre-op nutrition class.

Bariatric Surgery Preop Education book (PDF)

You should be working on your insurance and program requirements during this time.

If you are working on a ‘Medically Supervised Weight Loss Attempt’, be sure your health care providers are sending us the records, or obtain a copy to send to us. Fax records to: 843-876-4201

• Monthly visits should be once per month, about 30 days apart, and consecutive (3-6 months in a row, without any breaks)
• You can have your providers send us monthly progress notes or use a sample form (PDF). we have created to help streamline their process.

Many insurance companies require documentation of your history of attempts at losing weight; we have developed a Medical Necessity Form (PDF) to help your Provider document this.

Our program requires that you are smoke-free or nicotine-free before entering our program. You are required to eliminate all nicotine for 30 days before your first appointment with the surgeon. We will be checking urine nicotine at this first appointment. If your urine nicotine is positive, you will not be permitted to progress in the program until you have a negative urine test. Once you have proven nicotine cessation, you will undergo urine nicotine screening for 60 days or up until your surgery is scheduled.

Once all your requirements have been met, and records received, we will submit your clinical information to your insurance company for prior authorization.

Once all your program and insurance requirements have been met and records received (fax to 843-876-4201), we will call you to schedule your surgery date, preop visit, and anesthesia appointment (if needed).

Your clinical information will be submitted to insurance for prior authorization. This can take up to two weeks to receive approval.

You will be contacted to schedule your surgery date, as well as your pre-operative visit with the Nurse Practitioner and Registered Dietitian, about 1 to 2 weeks before surgery date.

You will also see the anesthesia team at Rutledge Tower; you may have additional lab work and EKG at this visit.

You will be admitted to the Ashley River Tower hospital the morning of your surgery through central registration the morning of surgery. You will be in the hospital for approximately 1-2 days and must have prior arrangements for transportation home from the hospital and an adequate care-giving plan for your first days at home.

You will receive extensive education about your hospital stay during the mandatory Pre-Surgery Education class.

Surgical weight loss is a program, not just a procedure, and we expect to have a lifelong relationship with you! We look forward to working with you and watching your weight loss and maintenance progress.

Routine clinic visits will be scheduled when you leave the clinic at one month, three months, six months, twelve months, eighteen months, two years, three years, and annually for life. If you leave without making an appointment, call the GI Surgery Scheduling Line at 843-792-7929.

If you relocate or need to have another provider order your routine bariatric lab work, we can facilitate this process to ensure labs are being ordered and reviewed.

We continually develop innovative resources, classes, and programs to suit your needs, and much of our information is disseminated through our website, Facebook page, or listserv - email peterama@musc.edu if you would like to be added.