Effective January 10, 2010
Bilateral/Multiple Surgical Procedures and Imaging Payment Policies Revised

As previously announced in the August 1, 2009 issue of Provider Update, Tufts Health Plan has revised its payment policies for bilateral and multiple surgical procedures and imaging services, and will implement those revised policies for claims processed on or after January 10, 2010.

Bilateral and Multiple Surgical Procedures
Tufts Health Plan has revised its Bilateral and Multiple Surgical Procedures Facility and Professional payment policies to more closely align with CMS’ code groups. In addition, we have also revised the current policy regarding multiple procedure reduction when two or more surgical procedures, including bilateral procedures, are performed by the same provider within the same operative session.

Multiple Imaging Procedures
Tufts Health Plan’s Multiple Imaging Procedures Lists have been revised to more closely align with CMS’ code groups subject to multiple imaging procedure reduction.

For more information, refer to the section on Reimbursement for Multiple Imaging Procedures in the Imaging Services Facility, Freestanding and Mobile Imaging, and Imaging Professional payment policies.

These and other payment policies are available in the Payment Policies section of our Web site. Copies of those documents are also available upon request by calling Provider Services at 888-884-2404.

August 1, 2009
Revised October 9, 2009
Updated December 23, 2009
Note: The information in this article was correct as of the date of posting and may not reflect subsequent policy changes.