tci General Surgery Coding Alert - 2002 Issue 5

Bariatric Surgery: Obesity-Related Conditions Key to Reimbursement

Bariatric surgery, typically performed on morbidly and super-obese individuals, includes any procedure that aims to restrict food intake. Although it is highly specialized and involves significant risk, Medicare and many other carriers will not pay for it simply because the patient is obese. Carriers are more likely to pay if the patient has other obesity-related conditions that are identified clearly in the surgeon's notes, says Anne Karl, RHIA, CPC, CCS-P, compliance coordinator with Surgical Consultants, a 10-surgeon practice in Edina, Minn. These conditions include, among others, congestive heart failure, uncontrolled diabetes mellitus and its manifestations, sleep apnea, severe arthritis...

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