Coding for deep enteroscopy procedures in an era of emerging technology.

摘要

In 2001, Hironori Yamamoto introduced an enteroscope that was fitted with an inflatable balloon at the tip combined with a flexible overtube that was also equipped with a balloon. By sequentially inflating and deflating the balloons, and by advancing and withdrawing the en-teroscope and overtube, he was able to demonstrate that deep, and at times, complete, small-bowel enteroscopy could be performed antegrade, via the mouth, or retrograde, via the anus. Combining these two procedures led to complete enteroscopy in a significant number of patients. Over the past 6 years, numerous studies confirmed that "double-balloon enteroscopy" (DBE) can indeed enable deep enteroscopy by both routes. Yet, these studies also pointed out that DBE is time consuming, physically demanding, and resource intensive. Within the past year, at least 3 other methods for performing deep enteroscopy (DE) have been described, and it is likely that additional technologies for this purpose lie just over the horizon. Like many new technologies, DE has evolved faster than existing codes and current reimbursement.