Does Texas Medicaid cover gastric bypass surgery?

Update to "Bariatric Surgery Benefits Now Available This is an update to an article that was posted on this website on January 9, 2008, titled, "Bariatric Surgery Benefits Now Available. " Effective for dates of service on or after July 1, 2008, bariatric surgery services will be benefits of Texas Medicaid (for clients 21 years of age and older) and the Texas Health Steps-Comprehensive Care Program (THSteps-CCP) (for clients birth through 20 years of age). Also, the previous article incorrectly stated that procedure code 2/8/F-43845 will be a benefit.

Procedure code 2/8/F-43845 is not a benefit of Medicare and will not be a benefit of Texas Medicaid. Click on the title to view the details The following procedure codes may be reimbursed for bariatric surgery services with prior authorization: Procedure Codes 2/8/F-43644 2/8/F-43645 2/8/F-43659 2/8/F-43770 2/8/F-43771 2/8/F-43772 2/8/F-43773 2/8/F-43774 2/8/F-43842 2/8/F-43843 2/8/F-43846 2/8/F-43847 2/8/F-43848 2/8/F-43886 2/8/F-43887 2/8/F-43888 Correction to previous article: Procedure code 2/8/F-43845 is not covered by Medicaire and will not be made a benefit of Texas Medicaid The procedure code(s) in column B in the table below are denied when billed with the same date of service by the same provider as the procedure code in column A: Column A: Procedure Code to be Considered for Reimbursement Column B: Procedure Code(s) to be Denied 2/8/F-43645 2/8/F-43644 2/8/F-43770 2/8/F-43848 2/8/F-43771 2/8/F-43848 2/8/F-43772 2/8/F-43848 2/8/F-47773 2/8/F-43772, 2/8/F-43848 2/8/F-43774 2/8/F-43772, 2/8/F-43848, 2/8/F-43888 2/8/F-43842 2/8/F-43848 2/8/F-43843 2/8/F-43848 2/8/F-43846 2/8/F-43644, 43848 2/8/F-43847 2/8/F-43645, 2/8/F-43846, 2/8/F-43848 2/8/F-43888 2/8/F-43887 Bariatric surgery requests for prior authorization for Texas Medicaid clients birth through 20 years of age are considered on a case-by-case basis by THSteps-CCP with documentation of medical necessity. Prior authorization is a condition for reimbursement; it is not a guarantee of payment.

Providers may fax or mail prior authorization requests for bariatric surgery services for clients who are birth through 20 years of age to the TMHP Comprehensive Care Program (CCP) Department at: Texas Medicaid & Healthcare Partnership Comprehensive Care Program (CCP) PO Box 200735 Austin, TX 78720-0735 Fax: 1-512-514-4212 Note: Providers may refer to the list of documentation requirements for clients 21 years of age and older to determine any other documentation that may be appropriate or necessary to include when requesting prior authorization for clients who are birth through 20 years of age For clients 21 years of age and older, bariatric surgery requests for prior authorization are considered when the information submitted documents all of the following: • A summary of the treatment provided for the client's comorbid conditions and how the client's response to standard treatment measures is unsatisfactory Prior authorization requests may be approved when bariatric surgery is medically necessary in order to treat medical conditions that are caused or significantly worsened by the client's obesity and the comorbid conditions cannot be adequately treated by standard measures unless significant weight reduction takes place. The severe nature of the conditions must be such that medical necessity is clear when taking into account the risks of the surgery • The patient has demonstrated compliance with a physician-directed nonsurgical weight loss program Documentation from the client's physician must indicate at least 12 months of compliance with a physician-directed, nonsurgical weight loss program within 18 months of the request date • The surgery is medically necessary The documentation must contain a description of why the bariatric surgery is medically necessary in the context of current treatment and the medically reasonable alternatives that are available. Bariatric surgery is considered to be medically necessary when the prior authorization request documents either of the following.

I cant really gove you an answer,but what I can give you is a way to a solution, that is you have to find the anglde that you relate to or peaks your interest. A good paper is one that people get drawn into because it reaches them ln some way.As for me WW11 to me, I think of the holocaust and the effect it had on the survivors, their families and those who stood by and did nothing until it was too late.