Stretta Procedure Form

Summary Of Evidence

N/A

Analysis of Evidence

N/A

Abstract:

The Stretta procedure delivers radiofrequency thermal energy to the lower esophagus as a treatment for gastroesophageal reflux disease (GERD). CGS Administrators considers the Stretta procedure to be investigational and therefore non-covered.

Limitations:

An extensive literature review documented the following information:

• efficacy based on objective physiologic measurements has not been shown;
• a clear mechanism of action has not been determined, and;
• significant long-term studies confirming efficacy and safety have not been carried out. The Stretta procedure is considered investigational and is not covered.
  
  Other Comments:
  
  For claims submitted to the Part A MAC: this coverage determination also applies within states outside the primary geographic jurisdiction with facilities that have nominated CGS to process their claims.
  
  Bill type codes only apply to providers who bill these services to the fiscal intermediary or Part A MAC. Bill type codes do not apply to physicians, other professionals and suppliers who bill these services to the carrier or Part B MAC.
  
  Limitation of liability and refund requirements apply when denials are likely, whether based on medical necessity or other coverage reasons. The provider/supplier must notify the beneficiary in writing, prior to rendering the service, if the provider/supplier is aware that the test, item or procedure may not be covered by Medicare. The limitation of liability and refund requirements do not apply when the test, item or procedure is statutorily excluded, has no Medicare benefit category or is rendered for screening purposes.
  
  For dates of service prior to April 1, 2010, FQHC services should be reported with bill type 73X. For dates of service on or after April 1, 2010, bill type 77X should be used to report FQHC services.