Wiki 43270 for treatment of Barretts

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ssmith955

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We are using 43270 for the Halo ablation for Barretts. However, we are also now getting denials especially from Private carriers that this code is investigational for the treatment of Barretts.
I need to write an appeal letter stating that 43270 is not investigational and the denial is debatable. Can anyone give me some sources about this code to show it is not investigational
and fight this denial? Thank you
 
I would look to see how far you MD goes with the scope it may end up being 43229 bc the Barrett's is located in esophagus only no need to go to duodenum or stomach.
 
I've seen where carriers are treating it as investigational if the Barretts muscosa is without dysplasia. They will only pay for Barretts with biopsy proven high grade dysplasia. Low grade is covered under certain circumstances. You'll have to check each individual payer's policy regarding this.
 
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