Section 16.03.09.432 - SURGICAL PROCEDURES FOR WEIGHT LOSS: COVERAGE AND LIMITATIONS01.Non-Surgical Treatment for Obesity. Services in connection with non-surgical treatment of obesity are covered only when such services are an integral and necessary part of treatment for another medical condition that is covered by Medicaid.02.Abdominoplasty or Panniculectomy. Abdominoplasty or panniculectomy is covered when medically necessary, as defined in Section 011 of these rules, and when the surgery is prior authorized by the Department. The request for prior authorization must include the following documentation: a. Photographs of the front, side and underside of the participant's abdomen;b. Treatment of any ulceration and skin infections involving the panniculus;c. Failure of conservative treatment, including weight loss;d. That the panniculus severely inhibits the participant's walking;e. That the participant is unable to wear a garment to hold the panniculus up; andf. Other detrimental effects of the panniculus on the participant's health such as severe arthritis in the lower body.Idaho Admin. Code r. 16.03.09.432