This change will apply to the dates of service on 4/1/26 and thereafter.
The plans that ate affected are commercial and Medicare.
Bundled payments:
The following codes will no longer be reimbursed separately-15374 and 49649, when billed with the following codes: venrtal hernia
Less than 3 cm- 49591 to 49594 and 49613 to 49616
3cm to 10 cm- same codes.
For Washington members/plans-fpr commercial plans- the effective date will be given following a regulatory review.
For Texas- for fully ensured plans- this will be only if such changes comply with regulatory requirenments. For all other plan types are affected by this change
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