Publication of New Category I CPT Code is an Important Step in Establishing Access to Minimally Invasive Technology for Patients with Reflux
SAN MATEO, Calif.–EndoGastric Solutions (EGS), developer of an incisionless approach to treat Gastroesophageal Reflux Disease (GERD), announced today that the American Medical Association (AMA) has created a new Category I Current Procedural Terminology (CPT®) code with a procedure descriptor associated with the company’s Transoral Incisionless Fundoplication (TIF®) procedure for reflux.
The code, 432XX1, covers Esophagogastric Fundoplasty Trans-Orifice procedures, and will enable physicians to specifically communicate information to payers about the TIF procedure which is used to treat patients with chronic GERD.
The application for the new code was jointly sponsored by four key specialty medical societies: American Gastroenterological Association (AGA), American College of Gastroenterology (ACG), American Society for Gastrointestinal Endoscopy (ASGE) and the Society of American Gastrointestinal and Endoscopic Surgeons (SAGES); this application was reviewed during the recent public CPT panel February meeting held in San Diego, California.
“AMA’s CPT Editorial Panel’s decision to add this Category I code in 2016 is significant as it enables healthcare providers better access to coding and payment structures in the U.S. than are currently available. This not only increases procedure choice for physicians but expands patient access for new technology for GERD patients,” said Philip Macdonald, Vice President, Healthcare Economics, Policy, and Reimbursement at EndoGastric Solutions.
The Summary of Panel Actions is a preliminary step; new and revised code descriptions may be further refined prior to implementation, scheduled for January 1, 2016.
“The AMA’s decision to create a unique CPT code that describes the transoral reconstruction of a defective gastroesophageal valve to prevent reflux is a significant milestone for GERD patients. It will allow well-selected GERD patients to receive an appropriate solution tailored to their disease stage,” said Skip Baldino, President and CEO of EndoGastric Solutions. “By creating this new code, the AMA has acknowledged the significant clinical evidence, including data from two randomized trials, and that this procedure has reached broad acceptance across both the GI and Surgeon physician community.”
“We are very pleased that the surgical and gastroenterological societies united in their support of the new code consistent with their continued efforts in advocating for evidence-based medicine and appropriate coding,” continued Baldino. “We feel that this is another important step in the process to provide broad availability to the innovative treatment option for millions of GERD patients.”
About Current Procedural Terminology (CPT®)
CPT codes are a listing of descriptive terms and identifying codes for reporting medical services and procedures. The purpose of CPT is to provide a uniform language that accurately describes medical, surgical, and diagnostic services, and thereby serves as an effective means for reliable nationwide communication among physicians and other healthcare providers, patients, and third parties. CPT® is registered trademark of the American Medical Association.