Notification of changes to Bupa schedule of procedures

Transcription

1 11 JULY 2016 Notification of changes to Bupa schedule of procedures This Bupa bulletin Schedule aims of to Procedures keep you up-to-date with any changes to procedure codes published in the Bupa Schedule of Procedures. To ensure you are always viewing the latest version of the Schedule, please refer to the new online code search tool found at The new changes in the Schedule effective this month are shown below. To help you ensure that you are using the current version, the Schedule is live and up-to-date if viewed via If you have any questions, please call Bupa Provider Services on Lines are open 8am to 6pm, Monday to Friday and 8am to 1pm on Saturday. Calls may be recorded and may be monitored. Thank you Dr Tim Woodman Medical Director healthcare policy and evidence, UK customer Notification of changes to Bupa schedule of procedures 1

2 Notice of changes to the Schedule 1) Description changes Code Description Approved Narrative Effective from B2234 Robot assisted laparoscopic adrenalectomy 11 th -July-2016 adrenalectomy B2224 Robot assisted laparoscopic adrenalectomy - bilateral adrenalectomy - bilateral H3581 Robot assisted laparoscopic rectopexy rectopexy J0220 Robot assisted hemihepatectomy Robotic assisted hemihepatectomy J5712 Robot assisted distal pancreatectomy Robotic assisted distal pancreatectomy K2560 Robot assisted replacement or repair of mitral valve Robotic assisted replacement or repair of mitral valve K4180 Robot assisted bypass for coronary artery(ies) including harvesting of grafts and endarterectomy (CABG) Robotic assisted bypass for coronary artery(ies) including harvesting of grafts and endarterectomy (CABG) K5765 Robot assisted ablation of atrial fibrillation by isolation of the pulmonary veins (including mapping) Robotic assisted ablation of atrial fibrillation by isolation of the pulmonary veins (including mapping) M0283 Robot assisted laparoscopic M0303 Robot assisted laparoscopic partial partial M1090 Robot assisted laparoscopic pyeloplasty pyeloplasty M3410 Robot assisted laparoscopic cystectomy +/- the removal of prostate cystectomy +/- the removal of prostate M6192 Robot assisted laparoscopic prostatectomy (including cystoscopy) prostatectomy (including cystoscopy) Q0752 Robot assisted laparoscopic subtotal subtotal 2

3 hysterectomy (+/- oophorectomy) hysterectomy (+/- oophorectomy) Q0791 Robot assisted laparoscopic total hysterectomy (+/- oophorectomy) total hysterectomy (+/- oophorectomy) Q0930 Robot assisted laparoscopic myomectomy myomectomy L8880 Clarivein treatment to long or short saphenous vein Endovenous mechanochemical ablation for varicose veins W3100 Bone graft (except where part of another Bone graft (as sole procedure) procedure) 2) Surgeon s category: 3) Anaesthetist s category: 4) Hospital category: 5) Footnote changes: 6) Follow-up consultation fee charge allowed on same day as procedure charge: 7) IV sedation or IV regional anaesthesia charge allowed alongside procedure charge: 3

4 8) Ophthalmic local anaesthesia charge allowed alongside procedure charge: 9) IC level 2 or 3 changes and LOS changes 10) Essential notes to the Schedule 11) Sub-chapter change (to align with CCSD Schedule): 12) New codes: Code Description SCC ACC HCC LOS IC level 2 IC level 3 Footnote Effective from M4780 Invasive urodynamic assessment including pressure/flow measurements MINOR MINOR O/P - - (ii) 1 st -August Consultations and procedures Bupa will fund eligible procedures carried out on the same day as an initial consultation. Bupa will not fund follow-up consultations carried out on the same day as most planned procedures. The procedure fee includes all component parts of that procedure including pre-operative assessment, the procedure itself and all routine aftercare, such as in-patient follow-up consultations and out-patient consultations on the same day. 4

5 There are some exceptions where Bupa will fund follow-up consultations on the same day as planned procedures and these are identified in the Schedule by (ii). For example, a Bupa customer who requires the insertion of a Mirena coil will be covered for the initial consultation and the cost of the procedure. If the coil cannot be inserted on the day of the initial consultation, the procedure itself is funded separately, but a follow-up consultation will not be funded. 13) Error Corrections 14) Code inactivations (as per CCSD Schedule changes): 15) CCSD coding principles ( unbundling ) additions Please refer to the CCSD website at: for a full list of the Coding Principles. Code Narrative Code Narrative Effective from B0410 Transsphenoidal hypophysectomy (including total) A3900 Repair of dura 11 th -July ) CCSD coding principles ( unbundling ) removals: No changes this month 5