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National Coverage Determination (NCD) for Intestinal Bypass Surgery (100.8)

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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.