Texas Medicaid Weight Loss Surgery


Medicaid May Cover Weight Loss Surgery In Some States


Medicaid coverage can vary a lot by state, but weight loss surgery may be covered by many state Medicaid programs under the following conditions:

  • Males are over the age of 15 and females are over the age of 13.
  • Body Mass Index is over 35 with at least one comorbidity such as sleep apnea, high blood pressure, high cholesterol or diabetes.
  • A psychological exam is taken and passed.
  • There is documentation that the beneficiary was unsuccessful at managing comorbidities with standard treatment.
  • Nutritional and psychological services are available before and after surgery.
  • There is a note from a doctor stating the surgery is medically necessary to achieve and maintain a healthy weight.
  • The beneficiary has a clear understanding that diet and lifestyle changes will be necessary after the procedure.
  • The beneficiary participates in a medically supervised weight loss program for six months within one year of the surgery.

In addition, the weight loss surgery must typically be performed at a facility that has achieved a Bariatric Center for Excellence designation, which is awarded to facilities that have demonstrated a history of excellence in bariatric surgery.

Bariatric Surgery For The Treatment Of Idiopathic Intracranial Hypertension

Levin and colleagues stated that IIH occurs most frequently in young, obese women. Gastric bypass surgery has been used to treat morbid obesity and its co-morbidities, and IIH has recently been considered among these indications. These investigators presented a case report of a 29-year old female with a maximum BMI of 50.3 and a 5-year history of severe headaches and moderate papilledema due to IIH. She also developed migraine headaches. After a waxing and waning course and various medical treatments, the patient underwent laparoscopic Roux-en-Y gastric bypass surgery with anterior repair of hiatal hernia. Dramatic improvement in IIH headaches occurred by 4 months post-procedure and was maintained at 1 year, when she reached her weight plateau with a BMI of 35. Pre-surgery migraines persisted. This added to the small number of case reports and retrospective analyses of the successful treatment of IIH with gastric bypass surgery, and brought this data from the surgical literature into the neurological domain. It offered insight into an early time course for symptom resolution, and explored the impact of weight-loss surgery on migraine headaches. The authors concluded that this treatment modality should be further investigated prospectively to analyze the rate of headache improvement with weight loss, the amount of weight loss needed for clinical improvement, and the possible correlation with improvement in papilledema.

Dr A Joseph Cribbins Iii Md Davinci Bariatric & General Surgeon

Dr. A. Joseph Cribbins III, MD is a highly skilled, esteemed, and board-certified bariatric surgeon who understands the struggles of weight loss. Dr. Cribbins is a national leader with 23 years of experience, and he enjoys the “Art of Bariatrics” because weight loss surgery restores health and transforms lives. He focuses on solutions, never judges patients, and is committed to achieving better surgical outcomes and results.

Dr. Cribbins began his general surgical training at Northwestern Memorial Hospital in Chicago, IL. During his internship and residency at Northwestern, he won the Dr. Harold L. Method Surgical award for outstanding performance in surgical skill, empathy, and dedication to patient care. He has also been a member of the American Society for Metabolic and Bariatric Surgery since 2012.

Dr. Cribbins has been the Medical Director of the Metabolic and Bariatric Surgery Committee program at Texas Health Presbyterian Hospital Plano for 17 consecutive years. He was recognized among D Magazine’s “Best Doctors” for bariatric surgery for 12 years, the “Best Doctor in Collin County” since 2011, and as a “Texas Super Doctor” in 2020 and 2021. He has specialized in Ultra-Minimally Invasive Da Vinci surgery since 2012.

Treating patients like family is the hallmark of his success and he prefers that everyone call him “Joe.”

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Silastic Ring Vertical Gastric Bypass

The Fobi pouch, developed by California surgeon Mathias A.L. Fobi, is a modification of gastric bypass surgery. The modifications to gastric bypass surgery are designed to prevent post-surgical enlargement of the gastric pouch and stoma.

In a traditional gastric bypass procedure, surgeons create a smaller stomach by stapling off a large section. A problem with the traditional procedure is that the staples can break down, causing the stomach to regain its original shape and patients to start gaining weight again. Also, the stomach opening that leads into the intestines, which in surgery is made smaller to allow less food to pass through, often stretches as the years go by. With the Fobi pouch, there is no use of staples rather, the stomach is bisected and hand-sewn them to maintain the separation. A synthetic band is placed around the stomach opening to keep it from stretching.

However, there is a paucity of direct comparative studies of the Fobi pouch to traditional gastric bypass surgery, causing colleagues to “question whether his technique is really an improvement on the traditional procedure” . All of the published literature has been limited to descriptive articles, case series, and a prospective non-randomized controlled study. These studies were from a single group of investigators, raising questions about the generalization of the findings.

Q: What Are The Potential Risks And/or Complications Of Weight Loss Surgery

Does Medicaid Cover Weight Loss Surgery In Texas

A: Most of the risks of bariatric surgery are similar to any other surgery in the abdomen. Bleeding, infection, need for corrective procedures, hernias, wound problems are all very low risks. Mortality risk after having a weight loss procedure of a rny bypass or a sleeve gastrectomy are less than 1%. Leak after a gastric bypass has a 1% risk and a sleeve operation has a 2% risk nationally. Our leak rate at BMI of Texas is < 1/1000. A leak with a band operation is extremely rare since no new connections or resections are being done. There is an increased risk of lap band slippage or shifting over the life of the band. These can usually be surgically corrected without need for removal of the band. The risk of an erosion of the band into the stomach is 1%. This, while rare, does require removal of the band. There are also risks of ulcers or swallowing problems. There is a risk of a blood clot forming in the legs or in the pelvis. If a blood clot breaks free and lodges in the lungs this is called a pulmonary embolism. This is uncommon, but is something all surgeons worry about as it is difficult to manage. Failure to lose weight, while rare, is risk as well. It usually involves a compliance problem however. There may be other risks of these operations that we dont yet know as weight loss surgery is a new field of medicine and some of the operations are very new. This list is a partial list of risks a more complete description is available at our seminar.

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Conversion To Sleeve Gastrectomy For Hypoglycemia Post

The 2017 American Society of Metabolic and Bariatric Surgery position statement on “Postprandial hyperinsulinemic hypoglycemia after bariatric surgery” stated that “Conversion of RYGB to SG has also been described in a few small series/case reports for complications related to RYGB. Reversal of RYGB with the addition of primary or staged SG specifically for treatment of refractory hyperinsulinemic hypoglycemia has been described in less than 10 patients with resolution of hypoglycemia symptoms in the majority without findings of short-term weight gain. As with RYGB reversal, these are technically challenging procedures with increased risk of complications, including a greater incidence of gastroesophageal reflux related to the addition of the SG. Currently, there is insufficient evidence to recommend this as treatment for hyperinsulinemic hypoglycemia”.

An UpToDate review on “Late complications of bariatric surgical operations” states that “Based on the theory that severe, disabling hypoglycemia after gastric bypass surgery occurs in a subset of patients with loss of gastric restriction, with resultant rapid food passage and absorption, restoration of gastric restriction can result in symptom resolution. Gastric restriction can be restored by surgical placement of a silastic ring or an adjustable gastric band around the pouch. In one series, symptoms resolved in 11 of 12 patients with this approach”.

Q: Why Do I Have To Quit Smoking If I Want My Surgery Done By Bmi Of Texas

A: Smoking will increase all potential risks of surgery including death. Tobacco increases the risk for blood clot formation in your legs which could lead to a pulmonary embolus, poor tissue and wound healing leading to a leak and infections, and anesthesia complications such as acute respiratory distress syndrome and pneumonia. Smoking will also cause gastric ulcerations and erosions in your new stomach pouch. You must quit smoking at least 6 weeks prior to your surgery or your surgery will be postponed. A smoke-free lifestyle must be maintained after surgery too.

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Attend Our Bariatric Seminar

During our Virtual Bariatric Seminar, you will learn about the different weight loss surgery options we offer and meet a bariatric surgeon virtually. This free event takes place via WebEx on Wednesday every month from 6:00pm to 7:00pm.

To attend our free Virtual Bariatric Seminar, please register online. You will receive a WebEx link via email prior to the seminar.

Getting Medicaid To Pay For Weight Loss Surgery

Hartford HealthCare Medical & Surgical Weight Loss

How can you get Medicaid to pay for weight loss surgery? This is becoming an increasingly common question. More and more people are looking to get Medicaid coverage for weight loss surgeries and procedures.

The reality is obesity is a problem in the United States, and its known to cause issues such as diabetes, high blood pressure , and cardiovascular diseases.

This is why Medicaid has committed to cover some weight-loss surgeries, as illustrated below.

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I Have Never Felt So Good About Myself 5

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I was blessed to find Texas Center for Bariactrics but more thankful that my consult made my nerves go away. The staff was so welcoming and honestly Dr. Cribbins is the coolest doctor Ive ever met! The whole process from consult, pre-op and surgery have been stress free and amazing. I want to thank you guys for being so personal with patients care and so welcoming like family. Also who can forget about Marty! You definitely made my day at my follow up appointment buddy. Thank you Dr. Cribbins for giving me a new start for a longer life

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Trusted Doctors Dedicated To Changing Lives For Over Two Decades

We are proud to say that our hospitals are MBSAQIP accredited centers by The American College of Surgeons and The American Society For Metabolic And Bariatric Surgery .

The ASMBS awards this MBSAQIP designation to leading centers in the field that demonstrates:

  • Exceptional patient care

“Impressive patient service and staff!Dr. Cribbins changes lives! Thank you!”Jake C.

Other Cpt Codes Related To The Cpb:


43659 Cholecystectomy 74240 Radiologic examination, upper gastrointestinal tract, including scout abdominal radiograph and delayed image, when performed single-contrast study 74246 Radiologic examination, upper gastrointestinal tract, including scout abdominal radiograph and delayed image, when performed double-contrast study, including glucagon, when administered

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Obesity Surgery In Children And Adolescents

According to available guidelines, obesity surgery is generally indicated for persons age 18 and older . Children and adolescents are rapidly growing, and are therefore especially susceptible to adverse long-term consequences of nutritional deficiencies from the reduced nutrient intake and malabsorption that is induced by obesity surgery. It is not known whether the benefits of obesity surgery in children and adolescents outweigh the increased risks.

Noninvasive Testing In Nonalcoholic Fatty Liver Disease

In an UpToDate review entitled Management of nonalcoholic fatty liver disease in adults, Chopra and Lai noted the following: Nonalcoholic fatty liver disease NAFLD ranges from the more benign condition of nonalcoholic fatty liver to nonalcoholic steatohepatitis , which is at the more severe end of the spectrum. In NAFL, hepatic steatosis is present without evidence of inflammation, whereas in NASH, hepatic steatosis is associated with lobular inflammation and apoptosis that can lead to fibrosis and cirrhosis.

In an UpToDate review entitled Epidemiology, clinical features, and diagnosis of nonalcoholic fatty liver disease in adults, Sheth and Chopra provide a distinction between nonalcoholic fatty liver disease and nonalcoholic steatohepatitis . They note that NAFLD is subdivided into nonalcoholic fatty liver and nonalcoholic steatohepatitis . In NAFL, hepatic steatosis is present without evidence of significant inflammation, whereas in NASH, hepatic steatosis is associated with hepatic inflammation that may be histologically indistinguishable from alcoholic steatohepatitis. The only method to definitively confirm or exclude a diagnosis of NASH and to assess disease severity is via a liver biopsy. Furthermore, the histologic diagnosis of NASH is based on the presence of hepatic steatosis in relation to hepatocyte ballooning degeneration and hepatic lobular inflammation .” Although fibrosis may be visible, it is not a required diagnostic feature for NASH.

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Da Vinci Surgery For General And Bariatric Surgery

Texas Center for Bariatrics & Advanced Surgery uses the ultra minimally invasive Da Vinci Xi® surgical system for bariatric and general surgery. This advanced surgical technology eclipses standards set by older technologies, such as traditional laparoscopic surgery.

While laparoscopic was once heralded for its “minimally” invasive capabilities, the Da Vinci Xi raises the standard of minimally invasive care with a high-definition 3D view for the bariatric surgeon. Da Vinci’s smaller incisions and greater precision mean less pain, reduced scarring, and faster healing.

The advanced capabilities of Da Vinci Xi are even more enhanced in the hands of our experienced surgeon. Drs. Cribbins and Chen have used the Da Vinci Xi system to help bariatric surgery patients lose weight since 2012.

Contraindications To Obesity Surgery

Medicaid covers weight loss surgery | Crystals Life

Surgery for severe obesity is a major surgical intervention with a risk of significant early and late morbidity and of perioperative mortality . Contraindications for these surgical procedures include peri-operative risk of cardiac complications, poor myocardial reserve, significant chronic obstructive airways disease or respiratory dysfunction, non-compliance of medical treatment, psychological disorders of a significant degree that a psychologist/psychiatrist would have thought would be exacerbated or interfere with the long-term management of the patient after the operation, significant eating disorders, or severe hiatal hernia/gastroesophageal reflux.

A Multidisciplinary Care Task Group identified contraindications to weight loss surgery, including unstable or severe coronary artery disease, severe pulmonary disease, portal hypertension with gastric or intestinal varices, and/or other conditions thought to seriously compromise anesthesia or wound healing. The Task Group also noted that weight loss surgery is contraindicated in those who are unable to comprehend basic principles of weight loss surgery or follow operative instructions. The Task Group stated that any combination of the following factors revisional surgery, male, greater than 50 years of age, BMI greater than 50 kg/m2, and obstructive sleep apnea, hypertension, and type 2 diabetes indicates high risk.

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Adjunctive Omentectomy To Bariatric Surgery

In a double-blind RCT, Andersson and colleagues examined if removal of a large amount of visceral fat by omentectomy in conjunction with RYGB would result in enhanced improvement of insulin sensitivity compared to gastric bypass surgery alone. A total of 81 obese women scheduled for RYGB were included in the study. They were randomized to RYGB or RYGB in conjunction with omentectomy. Insulin sensitivity was measured by hyperinsulinemic euglycemic clamp before operation and 62 women were also re-examined 2 years post-operatively. The primary outcome measure was insulin sensitivity and secondary outcome measures included cardio-metabolic risk factors. Two-year weight loss was profound but unaffected by omentectomy. Before intervention, there were no clinical or metabolic differences between the 2 groups. The difference in primary outcome measure, insulin sensitivity, was not significant between the non-omentectomy and omentectomy groups after 2 years. Nor did any of the cardio-metabolic risk factors that were secondary outcome measures differed significantly. The authors concluded that addition of omentectomy to gastric bypass operation did not result in an incremental effect on long-term insulin sensitivity or cardio-metabolic risk factors. They stated that the clinical value of adjunctive omentectomy to gastric bypass operation is highly questionable.

When Can I Start Exercising Again After Bariatric Surgery

In general, no exercise should be performed for the first two weeks after the surgery. Your doctor will then give you a checkup and let you know whether or not they recommend exercise. However, most patients can start doing daily walks after about 2 weeks, and more strenuous exercise after a few months.

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Mickey Patel Msn Aprn Fnp

Mickey grew up in Athens, Georgia and earned a Bachelor of Business Administration in Finance from the University of Georgia. His degree led him to the hospitality business where he bought and managed a hotel for many years.

Mickey decided to leave the hotel, and the hospitality management business behind and began his medical career in 2016. With a change in careers he went back to school and attended the Chamberlain College of Nursing earning a Bachelor of Science in Nursing.

With his nursing degree, he then enjoyed 5 fulfilling years as an operating room nurse at Texas Health Presbyterian Plano. He worked a variety of service lines from orthopedics, urology, gynecology, vascular and bariatrics… which is where he found his true passion being in bariatrics.

While operating beside Dr. Cribbins for five years he fell in love with bariatric surgery and how life changing the surgery was for patients. He decided to go back to school once again, while still working in the operating room, to become a nurse practitioner so that he could assist Dr. Cribbins in clinic, as well as in the operating room.

Mickey earned a Master of Science in Nursing FNP at the University of Texas, he is a nationally certified nurse practitioner specializing in bariatrics and certified in DAVINCI robotic assisted surgery.

He is a proud member of the American College of Nurse Practitioners and the Texas Nurse Practitioners.


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