Harvard Pilgrim is modifying its Gastroenterology Payment Policy, effective for dates of service beginning November 1, 2013. Under the revised policy, Harvard Pilgrim will reimburse for gastric emptying study (CPT 78264) performed in order to diagnose gastroparesis and will not reimburse when there is already a confirmed diagnosis of gastroparesis (536.3).
As part of this policy update, Harvard Pilgrim will reimburse for gastric emptying study when performed for diagnoses that are symptoms of gastroparesis (36 additional ICD-9 codes). This policy update ensures the appropriate reimbursement for gastric testing in order to diagnose suspected gastroparesis.
For complete information, including a full listing of covered indications, please refer to the updated Gastroenterology Payment Policy.