I
f your facility is thinking about offering
the innovative new approaches to treat
gastroesaphogeal reflux disease (GERD),
be warned that getting reimbursed might be a challenge.
"Everybody gets all excited when there's a new code out, but unfor-
tunately, just because you get a code doesn't mean you're going to get
paid on it," says Kathleen Mueller, RN, CPC, CCS-P, CMSCS, CGCS,
CCC, a coding and reimbursement expert from Lenzburg, Ill., and the
president of Ask Mueller Consulting.
She's referring to the new CPT Category 1 code (43210) covering
esophagogastric fundoplasty trans-orifice procedures. It went into
effect Jan. 1, and is being welcomed by the companies touting the TIF
1 3 2 • O U T PA T I E N T S U R G E R Y M A G A Z I N E • F E B R U A R Y 2 0 1 6
GERD Treatments Move
Forward, But Will You Get Paid?
• LESS INVASIVE GERD procedures that let practitioners access the stomach via the mouth now have a special CPT code, but payers still have to accept the new approach.
The new CPT code is here, but you may have to battle with payers.
Jim Burger
Associate Editor
