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Insurance Considerations

The BCIR is a well-known, approved procedure, listed in all the surgical procedure code manuals. Many people ask whether surgery to convert a standard conventional ileostomy to the BCIR is covered by health insurance. The answer is YES. The diagnosis is "malfunctioning Brooke ileostomy" which includes both physical problems with an ileostomy as well as emotional or psychological problems dealing with an ileostomy. Just the presence of an ileostomy requiring an external appliance is an approved indication for the BCIR surgery.

This is NOT a cosmetic operation. It is an operation to give a person control over the discharge of their intestinal waste, thereby avoiding the need for an external appliance. We participate actively in the process on your behalf, by telephone calls and by letters as well as dialogue with the Medical Director of your insurance plan. Our team participates on many plans which include HMO, PPO and indemnity insurance. If we do not participate, we will try to negotiate a rate as it is likely that they do not have anyone on there approved list that performs this specialized procedure.