Laya healthcare will provide benefit for an initial upper Gastroscopy procedure code 194 for:
Benefit is available for a repeat upper GI endoscopy, procedure code 194, as per the following clinical indications.
Note: New clinical presentation will not be excluded by a prior endoscopy, please refer to initial endoscopy clinical indicators and/or submit a detailed medical report with the claim.
No Consultant or hospital benefits are payable for a surveillance upper GI endoscopy except for the following clinical indications: