EndoGastric Solutions

a leader in the endoluminal treatment of digestive diseases

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Reimbursement Coding for TIF Procedure with EsophyX Device

CODING INFORMATION
EFFECTIVE 1/1/2019
For reimbursement assistance call (425) 307-9224

DESCRIPTION: The TIF procedure is an innovative and effective treatment for gastroesophageal reflux disease (GERD). Developed by EndoGastric Solutions® Inc., transoral fundoplication is performed from inside the patient’s stomach without incisions. This procedure delivers patient outcomes similar to those provided by conventional antireflux surgical procedures, but is less invasive, has fewer adverse effects, and does not limit future treatment options. Transoral fundoplication is able to repair the antireflux barrier, including reduction of hiatal hernia (≤ 2 cm), restoration of the angle of His, and re-creation of an antireflux valve with a minimum of 2cm in length and at least 270◦ in circumference similar to Toupet, Hill, and Belsey fundoplication procedures.

In a TIF 2.0 procedure, the patient is placed under general anesthesia so that the EsophyX® device, combined with a flexible endoscope for visualization, can be gently introduced into the stomach. The endoscope is retroflexed and the helical retractor is engaged into the tissue slightly distal to the Z line. Then, the fundus of the stomach is retracted and plicated around the distal esophagus utilizing the tissue mold and chassis of the device. After locking all the tissue handling elements, suction is applied via the device to position the GEJ under the diaphragm, and permits the reduction of hiatal hernia 2cm or smaller (if present). The fastener implants are then delivered through two layers of folded tissue as an anchor. The same maneuvers are repeated at 3 additional positions to create full thickness esophagogastric, partial wrap fundoplication; valves are anchored with at least 20 SerosaFuse® fasteners.

COMMONLY USED CODES

ICD-10-CM Diagnosis
K21.0 Gastro-esophageal reflux disease with esophagitis
K21.9 Gastro-esophageal reflux disease without esophagitis
K30 Functional dysphasia
R10.13 Dyspepsia NOS
K44 Diaphragmatic hernia without obstruction or gangrene
R12 Heartburn
Note: Underlying condition(s) should also be coded. Consult an ICD-10-CM manual for a complete list of diagnosis codes.
ICD-10-PCS Procedure Codes
0DV48DZ Restriction of Esophagogastric Junction with Intraluminal Device, Via Natural or Artificial Opening Endoscopic
  Note: ICD-10-PCS procedure codes are used specifically by hospitals to describe services and procedures provided during an in-patient confinement
DRG
MS-DRG 326 Stomach, Esophageal and Duodenal Procedures with MCC
MS-DRG 327 Stomach, Esophageal and Duodenal Procedures with CC
MS-DRG 328 Stomach, Esophageal and Duodenal Procedures w/o CC/MCC
Physician
CPT® Code 43210 Esophagogastroduodenoscopy, flexible, transoral; with esophagogastric fundoplasty, partial or complete, includes duodenoscopy when performed.
Outpatient Hospital Commercial
CPT® Code 43210 Esophagogastroduodenoscopy, flexible, transoral; with esophagogastric fundoplasty, partial or complete, includes duodenoscopy when performed.
Outpatient Hospital Medicare
CPT® Code 43210 EGD, flexible, transoral; w/ esophagogastric fundoplasty, partial or complete, includes duodenoscopy when performed. Ambulatory Payment Category (APC) 5362: Level 2 Laparoscopy and Related Procedures
Revenue Code
0278 Other Implants

DISCLAIMER: Health economic and reimbursement information provided by EndoGastric Solutions, Inc. is gathered from third-party sources and is subject to change without notice. The information contained in this reference is presented for information purposes only and does not constitute reimbursement or legal advice. It is always the provider’s responsibility to determine medical necessity, the proper site for delivery of any services and to submit appropriate codes and charges for services that are rendered. EGS recommends that you consult with your payers, reimbursement specialists and/or legal counsel regarding coverage, coding and payment matters. CPT five-digit codes, descriptions, two-digit modifiers and other data are copyright ©2019 American Medical Association. All rights reserved. The codes referenced here are not all-inclusive and are not intended to represent all coding options.

NP01787-01T

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This site is published by EndoGastric Solutions, Inc., and is intended as an information resource to help increase awareness of GERD-related disorders and the available treatment options. This site is not a substitute for medical advice from your physician. The contents of the site are for informational purposes only and are intended to be discussed with your physician. Never disregard any advice given to you by your physician or other qualified healthcare professional. Always seek the advice of a physician or other licensed healthcare professional regarding any questions you have about your medical conditions and treatments.
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© 2019 EndoGastric Solutions, Inc. All rights reserved. EndoGastric, EsophyX, SerosaFuse and TIF names and logos, are registered trademarks of EndoGastric Solutions.
All other product names and logos are trademarks or registered trademarks of their respective holders.

NP02410-01B

  • Company
    • Overview
    • Management Team
    • Board of Directors
    • Investors
    • Corporate Compliance
    • Careers
  • EsophyX Technology
    • Overview
    • SerosaFuse® Fasteners
    • EsophyX® Device
    • Physician Training & Education for TIF Procedure with EsophyX Device
    • Regulatory Labeling
  • TIF Procedure
    • Overview
    • Society Support
    • TIF vs Antireflux Surgery
    • TIF Procedure Reimbursement
  • Data
    • Overview
    • Bibliography
    • European Bibliography
    • Clinical Research
  • Support
    • Overview
    • Training and Education
    • TIF Procedure Reimbursement
    • Marketing Programs
  • News
    • Press Releases
    • Videos
    • Professional Events
    • Blog
  • Contact
  • Privacy
  • Social Media Policy
  • Terms of Use