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

February 2016

Bariatric Surgery and Coverage of CPT 43842


For dates of service beginning March 24, 2016, Harvard Pilgrim will no longer provide reimbursement for CPT 43842 (Gastric restrictive procedure, without gastric bypass for morbid obesity; vertical-banded gastroplasty). This change is being made based on a review of current clinical literature and physician feedback confirming that this procedure is no longer part of the standard of care. For more information, please refer to the Bariatric Surgeries Medical Review Criteria and the Gastroenterology Payment Policy.

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PUBLICATION INFORMATION

Eric H. Schultz,
President and Chief Executive Officer

Robert Farias,
Vice President, Network Services

Annmarie Dadoly,
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Joseph O'Riordan,
Writer

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Production Coordinator