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Medicare proposes revised coverage policy for bariatric surgery as a diabetes treatment

APCs Insider, December 26, 2008

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CMS announced a proposal November 17 to clarify its policies about Medicare coverage of bariatric surgery as a treatment for beneficiaries with type 2 (non–insulin dependent) diabetes.

In its announcement, CMS says type 2 diabetes is one of the comorbidities it would consider in determining coverage of bariatric surgery for a Medicare beneficiary who is morbidly obese.

The proposed standard for determining morbid obesity is a body mass index of at least 35. CMS coverage of bariatric surgery for these patients would also require the beneficiary to have a further serious health condition, such as hypertension, coronary artery disease, or osteoarthritis, the announcement says.

 (This was adapted from Briefings on APCs. To view the entire article, click here.)



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