Bariatric Surgical Management of Morbid Obesity
JH · Effective Oct 1, 2015
47 active Medicare policies list K21.00, and 6 commercial payer policies list it. See each policy's status for the code and its official source. Listing a code is not a coverage decision: read each policy’s source for the requirements that apply.
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JH · Effective Oct 1, 2015
JL · Effective Oct 1, 2015
JJ · Effective Oct 1, 2015
JM · Effective Oct 1, 2015
J9 · Effective Oct 1, 2015
J5 · Effective Oct 1, 2015
J8 · Effective Oct 1, 2015
JJ · Effective Jul 14, 2024
JM · Effective Jul 14, 2024
6 policies from 2 payers
Summary of the payer’s published policy. Not a coverage determination — confirm with the payer before submitting.
| Policy | Effective | Status of K21.00 |
|---|---|---|
| Esophageal and Airway pH Monitoring | Sep 25, 2023 | Covered |
| Gastroesophageal Reflux Disease (GERD) | Apr 25, 2023 | Covered |
| Gastrointestinal Manometry | Sep 11, 2023 | Covered |
| In Vivo Analysis of Gastro-Intestinal and Urothelial Lesions | Oct 17, 2023 | Covered |
| Policy | Effective | Status of K21.00 |
|---|---|---|
| Lower Esophageal Sphincter Augmentation Devices |
JE · Effective May 28, 2023
JF · Effective May 28, 2023
JJ · Effective May 14, 2023
JM · Effective May 14, 2023
J6 · Effective Jul 13, 2025
JK · Effective Jul 13, 2025
J9 · Effective Dec 12, 2021
JH · Effective Dec 12, 2021
JL · Effective Dec 12, 2021
J6 · Effective Oct 1, 2015
JK · Effective Oct 1, 2015
JJ · Effective Oct 1, 2015
JM · Effective Oct 1, 2015
J9 · Effective Oct 1, 2015
JJ · Effective Oct 1, 2015
JM · Effective Oct 1, 2015
JH · Effective Oct 1, 2015
JL · Effective Oct 1, 2015
JJ · Effective Oct 1, 2015
JM · Effective Oct 1, 2015
JL · Effective Jan 1, 2026
National · Effective Oct 1, 2026
J9 · Effective Oct 1, 2025
J5 · Effective Jun 16, 2026
National · Effective Jul 14, 2024
National · Effective May 14, 2023
National · Effective Jan 22, 2026
National · Effective Feb 13, 2025
J5 · Effective May 14, 2023
J6 · Effective Apr 1, 2026
JL · Effective Sep 10, 2026
J9 · Effective Sep 10, 2026
J6 · Effective Apr 1, 2026
National · Effective Aug 18, 2024
J9 · Effective Jan 1, 2026
National · Effective Oct 1, 2026
JL · Effective Oct 1, 2025
National · Effective Oct 1, 2025
| Jan 6, 2026 |
| Not covered |
| Paraesophageal Hernia Repair | Jan 6, 2026 | Covered |
|---|