August 29, 200718 yr Here is a change to the Tricare manual which has yet to be added to the manual and few seem to know about if you call them. CHANGE 55 6010.54-M JANUARY 30, 2007 SUMMARY OF CHANGES (Continued) CHAPTER 4 (Continued) 5. Section 13.2 (Surgery For Morbid Obesity). 43644, 43842, 43846, and 43848. No change. New CPT procedure codes were within procedure code range. We added the following to Exclusions: laparoscopy, gastric restrictive procedure (CPT procedure codes 43770 - 43774) and gastric restrictive procedure (CPT procedure codes 43886 - 43888) is unproven. Added “for gastric bypass procedures” for unlisted codes. 6. Section 20.1 (Nervous System). 61000 - 61860, 61863 - 63048, 63055 - 64999, 95961, 95962, 95970 - 95975, 95978, 95979. Pulmonary ateriovenous malformation (PAVM) was removed from paragraph III.B. because it did not belong in this chapter. New CPT procedure codes 61630, 61635, 61640 - 61642 added to Exclusions. Deleted CPT procedure codes 64561 and 64580 from paragraph IV.J. because they were the wrong codes for this procedure. New CPT procedure code range is 61000 - 61626, 61680 - 61860, 61863 - 63048, 63055 - 64999, 95961, 95962, 95970 - 95975, 95978, 95979. Link to PDF
August 29, 200718 yr Yep, that's just a helpful way of clueing the reps in that the lap band is definitely EXCLUDED as an experimental procedure.
Here is a change to the Tricare manual which has yet to be added to the manual and few seem to know about if you call them.
CHANGE 55
6010.54-M
JANUARY 30, 2007
SUMMARY OF CHANGES (Continued)
CHAPTER 4 (Continued)
5. Section 13.2 (Surgery For Morbid Obesity). 43644, 43842, 43846, and 43848.
No change. New CPT procedure codes were within procedure code range. We
added the following to Exclusions: laparoscopy, gastric restrictive procedure (CPT
procedure codes 43770 - 43774) and gastric restrictive procedure (CPT procedure
codes 43886 - 43888) is unproven. Added “for gastric bypass procedures” for
unlisted codes.
6. Section 20.1 (Nervous System). 61000 - 61860, 61863 - 63048, 63055 - 64999, 95961,
95962, 95970 - 95975, 95978, 95979.
Pulmonary ateriovenous malformation (PAVM) was removed from paragraph
III.B. because it did not belong in this chapter. New CPT procedure codes 61630,
61635, 61640 - 61642 added to Exclusions. Deleted CPT procedure codes 64561 and
64580 from paragraph IV.J. because they were the wrong codes for this procedure.
New CPT procedure code range is 61000 - 61626, 61680 - 61860, 61863 - 63048,
63055 - 64999, 95961, 95962, 95970 - 95975, 95978, 95979.
Link to PDF