Publication Number

100-3

Manual Section Number

100.8

Version Number

1

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)
• Original consideration for Obesity as an Illness (CAG-00108N)

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Page Last Modified: 4/23/2009 7:26:58 AM

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