TIF Procedure Reimbursement

Insurance reimbursement concerns are important to consider when deciding whether or not the TIF procedure with the EsophyX® device is right for your patients or practice. Published study results confirm the efficacy of the TIF 2.0 procedure with the EsophyX device. These trials, along with the dedicated CPT code 43210, should help facilitate claims approval.

The TIF 2.0 procedure is covered by Medicare / Medicaid and many private insurance plans. Click here for commonly used reimbursement codes.

Reimbursement

Navigating Reimbursement – Support

Pre-Authorization/Pre-Determination

  • EGS offers a full-service TIF Authorization Assistance Program, ensuring the payer reviews the patient’s medical necessity and individual health benefits prior to surgery.

Internal Appeal

  • If a pre-authorization is denied, we expedite the patient through all levels of internal appeal and communicate with all stakeholders involved in the process. Our advocates are ready to assist you with individualized appeal letters, proactive payer follow-up and support, and talking points for peer review.

External Medical

  • If an external medical review is necessary, we guide the patient through the entire process, providing talking points and access to medical literature to be as prepared as possible.
Treat a broader patient population with TIF 2.0
NP02605-01A