Billing and Coding: Bariatric Surgery for Treatment of Co-Morbidities Conditions Related to Morbid Obesity

Bariatric surgery to treat co-morbid conditions related to morbid obesity is payable when billed per CMS national instructions (CMS Pub 100-03 NCD Manual §100.1 and CMS Pub 100-04 Claims Processing Manual Chapter 32 §150). This local article enumerates additional diagnoses covered for Part A procedure codes and listed CPT codes; Type II diabetes complication codes referenced in §150.5.1 are not listed here but remain covered per the IOM. Claims must follow the cited NCD and Claims Processing Manual billing requirements and include the documentation required by the IOM for diabetes-related codes.

"Bariatric surgery for treatment of co-morbid conditions related to morbid obesity is payable when billed in accordance with CMS Pub 100-03 Medicare National Coverage Determinations Manual, Chapter ..."

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