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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.

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Yep, that's just a helpful way of clueing the reps in that the lap band is definitely EXCLUDED as an experimental procedure.

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