Harvard Pilgrim Health Care Home
  HPHConnect
 
  Learn more.
  Sign up for HPHConnect.
Medical Management
E-Transactions
HPHConnect
Pharmacy
For Your Patient
News Center
Network Matters
Newsletter Archives
Newsletter Registration
Newsroom
Office Support
Products
Provider Manual
Medicare Advantage
Research & Teaching
Resources & Links
 
Print    Text Size

Network Matters
News and Information for the
Harvard Pilgrim Health Care Network

April 2015

Medical Policy for Esophagogastroduodenoscopy 


Based on a thorough clinical analysis and review of the competitive landscape, Harvard Pilgrim has developed a new medical policy for reimbursement of esophagogastroduodenoscopy (EGD), a test used to examine the lining of the esophagus, stomach, and duodenum. This medical policy identifies the conditions for which EGD is medically necessary, as well as the conditions and situations where EGD is not appropriate. Please refer to Esophagogastroduodenoscopy Medical Policy for a list of the non-covered diagnosis codes. Effective for dates of service on or after July 1, 2015, claims for EGD submitted with these non-covered diagnosis codes will be denied.

Email this article to a colleague   


Network Matters Archives

Download printer-friendly version

HPHCURRENT EVENTS

Harvard Pilgrim 2015–2016 GIC Offerings

ACA Update: Fluoride Varnish and Hepatitis B Screenings

CLINICIAN CORNER

Prior Authorization of Select Surgical Procedures

Medical Policy for Esophagogastroduodenoscopy

Coverage for Reclast

P&T Committee Updates

Posttraumatic Stress Disorder’s Effect on Physical Health

OFFICE ASSISTANT

Reminder: Appointment Availability Standards

PUBLICATION INFORMATION

Eric H. Schultz,
President and Chief Executive Officer

Richard Weisblatt PhD,
Senior Vice President, Provider Network

Annmarie Dadoly,
Editor

Joseph O'Riordan,
Writer

Kristin Edmonston,
Production Coordinator