Bariatric Surgery - Medicare Advantage

Bariatric surgery — surgical management of morbid obesity (including procedures such as laparoscopic sleeve gastrectomy, gastric balloons, adjustable gastric bands and related interventions) for patients with obesity (BMI ≥30, including Class 2–3/severe obesity and those with obesity‑related comorbidities). Coverage, medical necessity criteria, billing/coding rules, and limitations (e.g., exclusions for cosmetic procedures, jurisdictional variation, prior‑authorization requirements, and contractor‑specific post‑global adjustment billing rules) are determined by CMS NCD 100.1 and the applicable MAC LCDs/LCAs and may vary by Medicare Administrative Contractor and geography.

"Surgical management of morbid obesity (referenced LCD L33411 / A57145 — First Coast Service Options)."

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