About this policy
CMS National Coverage Determination | ncd_id=87 | manual_section=100.6 | coverage_level_code=3 | national_coverage_type=True | under_review=False | lab_ncd=False
Coverage indications
Since the procedure is now considered obsolete, it is not covered.
Documentation requirements
Item/Service Description: Gastric freezing for chronic peptic ulcer disease is a non-surgical treatment which was popular about 20 years ago but now is seldom done. It has been abandoned due to a high complication rate, only temporary improvement experienced by patients, and lack of effectiveness when tested by double-blind, controlled clinical trials. Benefit Categories: 52 - Physicians' Services
Codes in this policy
Code numbers and each code’s status as the policy records it. CPT code descriptions are left out of this page, as are the passages that cite CPT codes; the official document has them.
Backwork has no codes on record for this policy. Check the source.