Medical Policy Revision: Endoscopic Radiofrequency Ablation or Cryoablation for Barrett's Esophagus

Effective May 10, 2017, Horizon Blue Cross Blue Shield of New Jersey will change the way we consider certain claims for the treatment of Barrett’s esophagus using radiofrequency ablation or cryoablation.

The guidelines of our revised medical policy, Endoscopic Radiofrequency Ablation or Cryoablation for Barrett's Esophagus, identifies when radiofrequency ablation or cryoablation is considered medically necessary or investigational.

We encourage you to review this revised policy in our Medical Policy Manual.

Based on the guidelines of our revised medical policy, Endoscopic Radiofrequency Ablation or Cryoablation for Barrett's Esophagus, and the submitted diagnosis code(s), claims for services provided on and after May 10, 2017 that include CPT^® codes 43229 and 43270 may pend while information required to determine medical appropriateness is requested and reviewed.

Unless Horizon BCBSNJ gives written notice that all or part of the above changes have been cancelled or postponed, the changes will be applied to claims for dates of service on and after May 10, 2017.

CPT^® is a registered mark of the American Medical Association.