AHA Coding Clinic® for HCPCS - 2011 Issue 4; ASK the EDITOR

Radiofrequency ablation via EGD or esophagoscopy

Our facility has started performing radiofrequency ablation procedures in the Gastrointestinal Center to treat Barrett’s esophagus. The radiofrequency ablation (RFA) procedures are performed via an esophagogastroduodenoscopy (EGD) or esophagoscopy. RFA is considered a non-invasive technique because of utilization of a balloon and thermal energy or heat to destroy abnormal cells in the esophagus. Our facility has been advised to report these procedures with CPT codes 43228, Esophagoscopy, rigid or flexible; with ablation of tumor(s), polyp(s), or other lesion(s), not amenable to removal by hot biopsy forceps, bipolar cautery or snare technique, 43257, Upper gastrointestinal endoscopy including esophagus, stomach, and either the duodenum and/or jejunum as appropriate; with delivery of thermal energy to the muscle of lower esophageal sphincter and/or gastric cardia, for treatment of gastroesophageal reflux disease, or 43258, Upper gastrointestinal endoscopy including esophagus, stomach, and either the duodenum and/or jejunum as appropriate; with ablation of tumor(s), polyp(s), or other lesion(s), not amenable to removal by hot biopsy forceps, bipolar cautery or snare technique. Please clarify for our facility which CPT code(s) would be reported for radiofrequency ablation procedures via EGD or esophagoscopy. ...

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