Bupa Policy Notes
Bupa Schedule of Procedures
Uplifts of Benefit
Bupa keeps the PMI market under constant review and following recent research and in response
to feedback that we have received from consultants we have uplifted the surgical benefit of 8
These codes are:
Current Bupa Revised Bupa
Procedure Procedure Narrative
Benefit Limit Benefit Limit
Surgical Discogram/Diagnostic intervertebral disc injection under X-
V5230 £167 £249
Fee ray control
65050 Discography £167 £249
H3322 Laparoscopic abdominoperineal resection £1,370 £1,725
H3320 Abdominoperineal resection of rectum and anus £1,370 £1,725
W3719 Metal on Metal Hip Replacement Arthroplasty Bilateral £1,370 £1,725
W3718 Minimally invasive hip resurfacing £837 £1,040
Surgical Bilateral autograft for anterior cruciate ligament
W7421 £716 £1,370
Fee reconstruction as a sole procedure
K6015 Implantation of bi-ventricular pacemaker £619 £1,040
Date June 2010
Schedule amendments and changes
The latest version of the Bupa Schedule of Procedures can be found at www.consultantnet.org.
The schedule is updated each time a new code is added or changed.
Over the next few weeks we will be introducing more than 100 new CCSD codes into the Bupa
Schedule of Procedure. Because of this we advise consultants not to print off copies as they will
quickly become outdated.
Coding Principles (previously known as Unbundling)
From September this year, Bupa will be adopting the CCSD coding principles (unbundling) table.
All CCSD schedule users should use a single CCSD code to describe the majority of common
clinical interventions. This single code fully describes the procedure from start to finish. The code
covers the actual operation itself and all component parts and additional procedures, which are
routinely or commonly performed with the operation. For example:
Wound dressing and care
Immediate post operative analgesia (e.g. nerve blocks, local anaesthetic infiltrations, local
anaesthesia to joint spaces
No common clinical intervention should routinely require more than one code but occasionally,
two procedures undertaken at the same time may legitimately require two codes to fully describe
In the event that more than one code is needed to describe a procedure, a new code request
should be made to CCSD so that an additional single code may be issued.
Chemotherapy and Radiotherapy Benefit Tables
Chemotherapy and Radiotherapy benefit tables are now on the Bupa Schedule of Procedures. We
will be issuing the new CCSD codes for these procedures in due course, but for now please use
the existing Bupa codes included in the table.
Dr Johann Carinus
Bupa Health and Wellbeing UK