Technology Assisted Surgical Procedures

Policy Update
Robotic Assisted Surgery

(Policy G-10004, effective 11/01/2023)

Beginning with dates of service on or after November 1, 2023, Robotic Assisted Surgery reimbursement policy for Anthem Blue Cross and Blue Shield will expand to include CPT^® codes for computer-assisted surgical systems.

This policy does not allow separate reimbursement for technology assisted services detailed in the Related Coding section. These services are considered integral to the primary surgical procedure, are included in the primary surgical procedure, and are not separately reimbursed.

The Related Coding section of the policy has been updated to include the following computer assisted surgical musculoskeletal navigation procedures:

• 0054T: Computer-assisted musculoskeletal surgical navigational orthopedic procedure, with image-guidance based on fluoroscopic images (list separately in addition to code for primary procedure)
• 0055T: Computer-assisted musculoskeletal surgical navigational orthopedic procedure, with image-guidance based on CT/MRI images (list separately in addition to code for primary procedure)

The policy has been renamed to Technology Assisted Surgical Procedures which defines both robotic assisted and computer assisted techniques.

For additional information, please review the Technology Assisted Surgical Procedures reimbursement policy at https://providers.anthem.com/wi.