Insurance Committee

Michael Cook, MD FACS FASMBS

Maria Iliakova, MD

Don Selzer, MD

Helmuth Billy, MD
Executive Council Liaison


Matthew Brengman, MD FASMBS, Senior Past Chair
Yijun Chen, MD
Christopher Crawford, MD FACS FASMBS
Francesca Dimou, MD FACS MS
Adrian Dobrowolsky, MD FACS
Philip Gachassin, MD MHCM FACS FASMBS (Access to Care Committee Co-Chair)
L. Renee Hilton-Rowe, MD (Access to Care Committee Chair)
Crystal Johnson-Mann, MD MPH FACS FASMBS (Diversity & Inclusion Committee Liaison)
Tanya Kajese, MD FACS FASMBS (Access to Care Committee Co-Chair)
Wael Khreiss, MD
Jason Krynicki
Peter LePort, MD FASMBS
Walter Lindstrom, JD
Sheetal Nijhawan, MD FACS
Jaime Ponce, MD FASMBS
Marc Sarran, MD
Michelle Scerbo, MD MS
John Tann, MD FASMBS
Darren Tishler, MD FACS FASMBS (Access to Care Co-Chair)

Ad Hoc

Chris Gallagher, Washington, D.C.

ASMBS Staff Liaison

Leslie Vinson


  • To advocate for healthcare policy that ensures patients access to high quality prevention and treatment of obesity.
  • To be a highly valued specialty society that serves the educational and professional needs of our diverse membership.


The Insurance Committee bridges the gap between the details of insurance coverage and coding and the practicing surgeon. We focus on education of the surgeon and office administrative staff on the trends and changes in insurance coverage, coding and insurance access. The committee acts as a liaison between the ASMBS, insurers and CMS on the specifics of coverage for bariatric procedures. The committee seeks to identify new and commonly performed bariatric procedures and act as a champion for the development of CPT codes for effective and efficient reimbursement. Finally, the committee acts in concert with other committees of the ASMBS on acute and chronic access to care issues.


  • Increase reimbursement for metabolic bariatric surgery
  • Ensure appropriate CPT Coding
  • Provide clarity on insurance issues to members
  • Be a resource to ASMBS State Chapters, Access and Membership and their staff

2023-2024 Committee Goals

  1. Publish the Ideal Bariatric Policy
  2. Publish the “National Correct Coding Initiative Enacts New PTP Coding Edit For Primary Bariatric Surgery and Paraesophageal Hernia Repair 2015” Update
  3. Update Insurance FAQs
  4. Appeals Toolkit – Collaboration with Access to Care and Community/Independent Practice Committees
  5. Position Statement for Insurances to Accept RYGB as Treatment for Other Indications
  6. Ongoing:
    • Respond to member insurance coding inquiries via the email “coding hotline”
    • Maintain Bariatric Coding Insurance Toolkits: evaluate and update CPT and ICD-10 Codes for Bariatric Surgery, and prepare for bariatric CPT codes review
    • Communicate with State Chapters and Access to Care Committees to identify local & national insurance issues that affect access to care with policy plan changes and other restrictions affecting metabolic bariatric surgery
    • Monitor AMA CPT or RUC issues that would involve metabolic bariatric surgery
    • Respond to CMS requests for information

Specific Projects that Achieve Goals and Objectives

  1. Final draft of Ideal Bariatric Policy in progress
  2. Final draft of NCCI Update in progress
  3. Providing and reviewing denial and appeal resources for an Appeals Toolkit
  4. Review of FAQ emails from 2015-present, separated by topic, in progress
  5. Position Statement RYGB as Treatment for Other Indications Position Statement approved and in progress
  6. Ongoing:
    • Frequent and timely responses to member insurance “hotline” inquiries
    • Develop and pursue need for CPT Codes for bariatric issues as needed, and approach AMA CPT panel as required
    • Communication between insurance carriers’ Medical Directors, ASMBS State Chapter Presidents and members, ASMBS members, and Access to Care Committee on local and national insurance issues
    • Review CMS changes and respond to those affecting membership and the associated impact on access to care

2023-2024 Completed Projects

  1. Continued to be a valuable resource for members on coding and billing queries and helped resolve their issues

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