MEDICAID AND MEDICARE SURGEONS LIST!
On a daily basis we get calls from members in desperate need of surgeons that will accept Medicaid and or Medicare for Bariatric surgery. It breaks our hearts when we have to say "we don't know of any surgeons in your state we can refer you to".
Can you please help us? If you know of any surgeons in your state that accepts Medicaid and or Medicare, will you list their:
If they accept Medicare and or Medicaid
This list will remain here for our members to access and use.
Thank you so much!!!
I hope that this information will be helpful to folks in NC and around the nation.
The program at Duke accepts Medicare. Their website is www.dukewls.org. Duke does their surgery at Durham Region Hospital in Durham NC. (Durham Regional Hospital is now part of the Duke Hospital System).
Their are at least 8 centers in NC that are recognized by Medicare as Centers of Excellence. When someone has Medicare, they must use an ASBS certified COE for Medicare to cover. This is true throughout the US. To find out which programs have obtained the COE designation you can access the Centers for Medicare/Medcaid Services at the following link: http://www.cms.hhs.gov/MedicareApprovedFacilitie/BSF/list.as p?listpage=2 Then plug in the appropriate state to display the centers approved for a particular state. This information is constantly updated, so it provides the most current information available. This is the list that appeared when I did a search for Medicare Approved Facilities in NC:
|Facility Name||Provider Number||Date approved||State|
|Cape Fear Valley Health System||N/A||02/24/2006||NC|
|Durham Regional Hospital||N/A||05/17/2006||NC|
|FirstHealth Moore Regional Hospital||340115||09/01/2006||NC|
|Frye Regional Medical Center||N/A||02/24/2006||NC|
|New Hanover Regional Medical Center||N/A||02/24/2006||NC|
|NorthEast Medical Center||N/A||02/24/2006||NC|
|Pitt County Memorial Hospital||340040||02/20/2007||NC|
|The Presbyterian Hospital||340053||06/06/2007||NC|
I have medicare and I know that they accept that, but because the are on the CMS list of approved providers/facilities, I believe that they accept both. (The CMS is the Center for Medicare/Medicaid Services.)
on 4/5/08 2:16 pm
The proposed changes to Medicaid are available online,
Below are the proposed changes in coverage allowing other WLS, PLEASE NOTE THEY ARE PROPOSED AND NOT IN EFFECT, MEDICAID HAS not set a date of when, if at all these changes will be made.
1. gastric bypass with roux limb 150 cm or less (Roux-en-Y) (CPT code 43846 or 43644), or
2. Adjustable gastric banding, for recipients with a BMI of less than 50 (the open gastric banding is covered only when complications occur during the laparoscopic attempt) Recipients with a BMI greater than or equal to 50 will be considered on a case by case basis when information is provided as to the necessity of this procedure for the specific recipient (CPT code 43770 or 43999); or
3. Biliopancreatic diversion with or without duodenal switch, for the most severely obese recipients (typically with a BMI greater than or equal to 50), to be considered on an individual basis with appropriate documentation of the indications for this procedure under current standards of care (CPT code 43845, 43847, 43645 or 43659); or
4. Gastric bypass, with small intestine reconstruction to limit absorption, with roux limb greater than 150 cm (long limb Roux-en-Y) for recipients with a BMI greater than or equal to 50, to be considered on an individual basis (CPT code 43847 or 43645).