tci Medicare Compliance & Reimbursement - 2004 Issue 17

Coverage: New Codes Coming For Bariatric Surgeries

Carrier loosens red tape on stomach-stapling and bypass operations.New policies from at least one carrier are going to make life easier for physicians who perform bariatric operations. Compared to older, more restrictive policies, January's local coverage decision from Part B carrier Noridian (L14980) seems fairly easy-going. Noridian will accept just one of a number of secondary diagnoses along with a primary diagnosis of morbid obesity. These include Type II diabetes, hypertension, gastroesophageal reflux, sleep apnea, urinary incontinence, venous stasis ulcer or degenerative joint disease involving the lower back, hips, knees, ankles or feet. Though Noridian's policy does...

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