Monday, July 26, 2010

Does Medicare cover gastric bypass

Gastric Bypass

Medicare may cover gastric bypass procedures provided the guidelines outlined in the following Coverage Issue Manual and National Coverage Determination references are met. These procedures may be considered medically reasonable and necessary if the patient's obesity is aggravating a condition such as hypertension, asthma, diabetes, etc, and the treatment of the obesity is integral to the treatment of the underlying disease. The medical record should include such supporting documentation as well as the patient's weight and body mass index. CPT codes 43846 and 43847 are to be used for open procedures but laparoscopic procedures should be billed with an unlisted code and submitted with the above supporting documentation.

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