Surgery for Diabetes
Effective for services performed on and after February 12, 2009, CMS determines that open and laparoscopic Roux-en-Y gastric bypass (RYGBP), laparoscopic adjustable gastric banding (LAGB), and open and laparoscopic biliopancreatic diversion with duodenal switch (BPD/DS) in Medicare beneficiaries who have type 2 diabetes mellitus (T2DM) and a BMI less than 35 are not
reasonable and necessary under section 1862(a)(1)(A) of the Social Security Act, and therefore are not covered.
Issued by: Centers for Medicare & Medicaid Services (CMS)
Issue Date: December 19, 9038
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