LCD/NCD Portal

NCD100.8

 

INTESTINAL BYPASS SURGERY

 

 

Effective Date of this Version

• This is a longstanding national coverage determination.

• The effective date of this version has not been posted.

 

Benefit Category

• Inpatient Hospital Services.

• Physicians' Services.

• Note: This may not be an exhaustive list of all applicable Medicare benefit categories for this item or service.

 

Indications and Limitations of Coverage

• The safety of intestinal bypass surgery for treatment of obesity has not been demonstrated.

• Severe adverse reactions such as steatorrhea, electrolyte depletion, liver failure, arthralgia, hypoplasia of bone marrow, and avitaminosis have sometimes occurred as a result of this procedure.

• It does NOT meet the reasonable and necessary provisions of §1862(a) (1) of the Act and is NOT a covered Medicare procedure.

 

Cross Reference

• See §§40.5 and 100.1 of the NCD Manual.

 

National Coverage Analyses (NCAs)

• This NCD has been or is currently being reviewed under the National Coverage Determination process.

• The following are existing associations with NCAs, from the National Coverage Analyses database.

• First reconsideration for Bariatric Surgery for the Treatment of Morbid Obesity (CAG-00250R) opens in new window

• Second reconsideration for Bariatric Surgery for the Treatment of Morbid Obesity (CAG-00250R2) opens in new window

• Original consideration for Obesity as an Illness (CAG-00108N) opens in new window

 

 

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