A surgical procedure often referred to as a whipple procedure, to treat pancreatic cancer. The procedure involves the removal of the head of the pancreas, the first part of the small intestine, the gallbladder and the bile duct. The remaining organs are reattached to restore the ability to digest food after surgery.
The Bundled Rate plus Outlier Per Diems includes:
1. Those comprehensive facility services, supplies, and equipment necessary to perform the Bundled Procedure and rendered by PROVIDER 2. Those professional services necessary to perform the Bundled Procedure and rendered by a Physician 3. The treatment of any complication or concurrent related illness associated with or resulting from the performance of the Bundled Procedure The Bundled Rate Period covers the 1 day(s) prior to the procedure for the scheduled Accarent Procedure and up to 14 inpatient days in the hospital. Should the length of stay exceed 14 inpatient days, then per diem outlier payments will be applicable for each subsequent inpatient day. Covered outpatient follow-up services related to the bundled procedure beginning on the day of discharge through 30 calendar days are included in the bundled price.
There are no exclusions.
Candidacy for the bundled procedure will be determined by the Provider.