About this policy
Italicized font represents CMS national language/wording copied directly from CMS Manuals or CMS Transmittals. Contractors are prohibited from changing national NCD language/wording. Bariatric Surgery for Treatment of Morbid Obesity is a payable Medicare service when billed in accordance with instructions outlined in: CMS Pub 100-03 Medicare National Coverage Determinations (NCD) Manual , Chapter 1 – Coverage Determinations, Part 2 (Sections 90-160.2), Section 100.1 - Bariatric Surgery for Treatment of Co-morbid Conditions Related to Morbid Obesity (Effective September 24, 2013). CMS Pub 100-04 Medicare Claims Processing Manual , Chapter 32 – Billing Requirements for Special Services, Section 150- Billing Requirements for Bariatric Surgery for Morbid Obesity. This local coverage Article lists the additional diagnoses that are covered for bariatric surgery for treatment of co-morbid conditions related to morbid obesity for the procedure codes for Part A providers found in CMS Pub 100-04 Medicare Claims Processing Manual , Chapter 32 – Billing requirements for Special Services, Section 150- Billing Requirements for Bariatric Surgery for Morbid Obesity; and the listed CPT codes in the article. The diagnoses codes listed in section 150.5.1 - ICD Codes for Type II Diabetes Mellitus Complication are not included in this article but are covered based on the IOM.
Codes in this policy
Code numbers and each code’s status as the policy records it. CPT code descriptions are left out of this page, as are the passages that cite CPT codes; the official document has them.
| Code | Code system | Status in this policy |
|---|---|---|
| 43644 | HCPCS | Covered |
| 43645 | HCPCS | Covered |
| 43770 | HCPCS | Covered |
| 43775 | HCPCS | Covered |
| 43845 | HCPCS | Covered |
| 43846 | HCPCS | Covered |
| 43847 | HCPCS | Covered |
| 43999 | HCPCS | Covered |
| E10.10 | ICD10CM | Covered |
| E10.11 | ICD10CM | Covered |
| E10.21 | ICD10CM | Covered |
| E10.22 | ICD10CM | Covered |