Reimbursement policy update: Multiple and Bilateral Surgery Processing - Professional

Material Adverse Change (MAC)

 

Beginning with dates of service on or after January 1, 2023, Anthem Blue Cross and Blue Shield will update the Related Coding section of the policy with the following:

 

• Added CPT code 43497 to base code 43235 Esophagogastroduodenoscopy (EGD) with the reduction of 100% primary and 25% subsequent

 

For specific policy details, visit the reimbursement policy page at anthem.com.

 

WIBCBS-CM-006904-22-CPN6702