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  • Bariatric Surgery Evaluation Form - Upmc.com

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For Office Use Only Date Received BMI Division of Minimally Invasive Bariatric and General Surgery Anita Courcoulas, MD Giselle Hamad, MD Carol McCloskey, MD Ramesh Ramanathan, MD INITIAL EVALUATION.

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Z98. 84 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. The 2023 edition of ICD-10-CM Z98.

ICD-10 code Z98. 84 for Bariatric surgery status is a medical classification as listed by WHO under the range - Factors influencing health status and contact with health services .

Your doctor and surgeon only get to know what is significant for your bariatric surgery. The psych evaluation focuses on your behavior, psychological symptoms, and understanding of the surgery. For instance, the psychologist may ask about substance use to identify the risk of food and substance addiction post-surgery.

Because the surgery must be deemed necessary, and you must provide proof of previous failed weight loss attempts, it can take up to four months for Medicare to approve your bariatric surgery.

In providing a pre-surgical assessment of a candidate for gastric bypass surgery, select the appropriate health and behavior assessment CPT code for evaluating the patient depending on whether it is an initial evaluation (code 96150) or a reassessment (code 96151).

Assessment for bariatric surgery 707206008.

ICD-10 code R63. 4 for Abnormal weight loss is a medical classification as listed by WHO under the range - Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified .

The patient has a family history of weight-related ailments including [Medical conditions such as obesity, hypercholesterolemia, and diabetes.] I hereby request pre-authorization for bariatric surgery to include [Mr./Ms./Mrs.] [Patient Last Name's] policy benefits and coverage. Thank you for your consideration.

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© Copyright 1997-2025
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Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
DMCA Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
All Forms
Search all Forms
Industries
Forms in Spanish
Localized Forms
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232