Obesity services outside of mandated EPSDT services are not explicitly mentioned. All requests for bariatric surgery must be prior authorized. This includes the surgeon, assistant surgeon (if medically necessary), anesthesiologist, and facility. Requests for prior authorizations of bariatric surgery must be submitted in writing. Specific prior authorization criteria not found. DISTRICT OF COLUMBIA Department of Health Care Finance Nutritional Assessment/Counseling Pharmaceutical Therapy Bariatric Surgery Adults: Not explicitly mentioned Excluded drugs include: Prior authorization required. Anti-obesity drugs CPT Codes: 96151-96155, 99401 - 99404, 99411, Gastric bypass requires written justification and prior S9470, S9445, S9452, 97802-97804 authorization. EPSDT: Specific prior authorization criteria not defined. Obesity services outside of mandated EPSDT services are not explicitly mentioned.
Obesity services outside of mandated EPSDT services are not explicitly mentioned. All requests for bariatric surgery must be prior authorized. This includes the surgeon, assistant surgeon (if medically necessary), anesthesiologist, and facility. Requests for prior authorizations of bariatric surgery must be submitted in writing. Specific prior authorization criteria not found. DISTRICT OF COLUMBIA Department of Health Care Finance Nutritional Assessment/Counseling Pharmaceutical Therapy Bariatric Surgery Adults: Not explicitly mentioned CPT Codes: 96151-96155, 99401 - 99404, 99411, S9470, S9445, S9452, 97802-97804 EPSDT: Obesity services outside of mandated EPSDT services are not explicitly mentioned. Excluded drugs include: Anti-obesity drugs Prior authorization required. Gastric bypass requires written justification and prior authorization. Specific prior authorization criteria not defined.