Gastric Bypass Medical Necessity

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Gastric bypass (Roux-en-Y) - Mayo Clinic

https://www.mayoclinic.org/tests-procedures/gastric-bypass-surgery/about/pac-20385189

Gastric bypass is done to help you lose excess weight and reduce your risk of potentially life-threatening weight-related health problems, including: Gastroesophageal reflux disease Heart disease High blood pressure High cholesterol Obstructive sleep apnea Type 2 diabetes Stroke Cancer Infertility See more

Weight-loss surgery: Is it an option for you? - Mayo Clinic

https://www.mayoclinic.org/healthy-lifestyle/weight-loss/in-depth/gastric-bypass-surgery/art-20046318

Weight-loss surgery changes the shape and function of your digestive system. This surgery may help you lose weight and manage medical conditions related …

Guidelines for Medical Necessity Determination for …

https://www.mass.gov/doc/guidelines-for-medical-necessity-determination-for-bariatric-surgery/download

For adults, bariatric surgery is generally considered for refractory morbid obesity that persists despite medical therapy. To be considered medically necessary, all …

LCD - Bariatric Surgical Management of Morbid Obesity …

https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?LCDId=35022&DocID=L35022

Notice: Services performed for any given diagnosis must meet all of the indications and limitations stated in this policy, the general requirements for …

Medical Necessity - Bariatric Surgery

https://www.bariatric.us/medical-necessity.html

BMI of patient is 40 or higher (morbidly obese), or BMI of patient is between 35 - 40 with obesity comorbidities BMI is a measurement of a person's body …

Obesity Surgery - Medical Clinical Policy Bulletins | Aetna

https://www.aetna.com/cpb/medical/data/100_199/0157.html

Gastric bypass had more serious AEs than did the lifestyle-medical management intervention, 66 events versus 38 events, most frequently GIl events and surgical …

Do You Need a Letter of Medical Necessity for Bariatric …

https://www.healthylifebariatrics.com/do-you-need-a-letter-of-medical-necessity-for-bariatric-surgery/

A Letter of Medical Necessity (LOMN) is a document that tells health insurance companies that a medical procedure is needed to preserve your life. …

Bariatric Surgery for Treatment of Co-Morbid Conditions …

https://www.cms.gov/medicare-coverage-database/view/ncd.aspx?NCDId=57

The following are descriptions of bariatric surgery procedures: 1. Roux-en-Y Gastric Bypass (RYGBP) The RYGBP achieves weight loss by gastric restriction and …

MassHealth Guidelines for Medical Necessity …

https://www.mass.gov/guides/masshealth-guidelines-for-medical-necessity-determination-for-bariatric-surgery

MassHealth MassHealth Guidelines for Medical Necessity Determination for Bariatric Surgery The MassHealth Guidelines for Medical Necessity Determination (Guidelines) …

BCBS FED and Florida Blue's Weight Loss …

https://www.obesitycoverage.com/bcbs-federal-employee-program-and-florida-blue-weight-loss-surgery-requirements/

Gastric bypass and Lap-band procedures are covered. Gastric Sleeve is usually covered as well. BCBS Florida Pre-Approval Requirements BMI of 35 or greater …

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