Wiki Barrx Halo esophageal ablation


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Would anyone know the appropriate code for this procedure? Some payors policy manuals state code is 43228 or 43258 (though I dont see why it would be UGI if procedure is done in the esophagus), yet other payors have it as 43257:

"37 yo female patient presents for an outpatient esophagoscopy/ Ablation maneuver
Indications: Barret's ablation

Findings: An ablation maneuver was performed. The top of the gastric folds was measured at a 35cms in the incisors. The top of the intestinal metaplasia was measured at 20cms. A guidewire was placed was used to irrigate the esophagus. The endoscope ws introduced with the ablation electrode attached. Barrett's tissue was targeted from proximal to distal, treating islands, tongues circumferential at the gastroesophageal junction. The endoscope with ablation electrode was positioned under direct visualization so that the ablation electrode was in contact with any Barrett's tissue. Energy was applied twice. The elecectrode was then moved to the next, intestinal, metaplasia area. Ablation was then repeated. The ablated area was cleaned of coagulative debris. The ablation electrode and endoscope were removed, cleaned and reintroduced. A second set was applied as in the first treatment. The endoscope and ablation electrode were then removed. There were islands of Barrett's at 20cm-22cm. Ther was circumferential Barrett's at 23cm-25cms. There were islands of Barrett's at 32-35cms.

Summary: An ablation procedure for treatment of Barrett's Esophagus was performed."

I really appreciate the help!!! :eek:
Based upon this documentation, I would use 43228. I'm not sure what you mean about the UGI part, but 43228 is for an esophagoscopy with ablation. 43258 is used for a Barrett's ablation that includes a full EGD. These are the codes provided to us by the Rep's for the ablation equipment company as well. 43257 would not be the correct code.
Thank you very much for your reply. UGI just means "upper GI" and is often used interchangeably w/ EGD.

Have a great day,

Isela Coutin BSc, CPC, CCS, CPMA
Does anyone know what codes to use next year for the BARRX procedure since 43228 and 43258 are being deleted from CPT?