43281 Insurance Policy Changes

CPT 43281, in plain terms, covers A minimally invasive surgery to fix a hernia that forms beside the esophagus using a small camera. CPT 43281 is referenced in 3 tracked payer policy changes from Providence Health Plan and Health Net. For billers and coders, staying current on payer-specific coverage criteria, reimbursement rules, and prior-authorization requirements for CPT 43281 is critical to clean claim submission. Each entry below links to the full policy analysis with effective dates and action steps.

Official descriptor: CPT 43281 on AAPC