Health Information Management

Medicare announces final coverage policy for bariatric surgery as a diabetes treatment for certain individuals

APCs Insider, February 20, 2009

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CMS announced February 12 a clarification of its policy for Medicare coverage of bariatric surgery as a treatment for certain beneficiaries with type 2 (or non-insulin-dependent) diabetes.

The decision specifies type 2 diabetes as one of the comorbidities CMS will consider to determine coverage for bariatric surgery on a morbidly obese Medicare beneficiary. A body-mass index (BMI) of at least 35 indicates a morbidly obese person. Medicare will not cover bariatric surgery to treat type 2 diabetes in a beneficiary with a BMI below 35. You can view the decision memorandum on the CMS coverage Web site.

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