Reimbursement policy update:  Bundled Services and Supplies - professional

Beginning with dates of service on or after February 1, 2021, we will update our Bundled Services and Supplies Section 2 Coding list to indicate that the following codes:

 

• 43281 - laparoscopy, surgical, repair of paraesophageal hernia, includes fundoplasty, when performed; without implantation of mesh,
• 43282 - laparoscopy, surgical, repair of paraesophageal hernia, includes fundoplasty, when performed; with implantation of mesh or other prosthesis,
• 43283 - laparoscopy, surgical, esophageal lengthening procedure,
• 43332 - repair paraesophageal hiatal hernia (including fundoplication), via laparotomy, except neonatal; without implantation of mesh or other prosthesis, and
• 43333 - repair paraesophageal hiatal hernia (including fundoplication), via laparotomy, except neonatal; with implantation of mesh or other prosthesis, 

 

are not eligible for separate reimbursement when reported with bariatric procedure codes 43644, 43645, 43770, 43771, 43772, 43773, 43774, 43775, 43842, 43843, 43845, 43846, 43847, 43848, 43886, 43887 and 43888. 

 

Additionally, the Bundled Services Section 2 coding list will be updated to include the telehealth originating site facility fee HCPCS code (Q3014) when reported with an E&M code in place of service 11.

 

For more information about this policy, visit the Reimbursement Policies page at anthem.com.  

 

754-1120-PN-NE