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ACG

h.o.l.M.E.S.

Automated Clinical Guidelines

Gastrointestinal & General Surgery

Indicates Non-covered Service
Ablative Treatments for Malignant Breast Tumors
Ductal Lavage & Suction Collection Systems
Intraoperative Assessment of Surgical Margins During Breast-Conserving Surgery with Radiofrequency Spectroscopy or Optical Coherence Tomography
Minimally Invasive Procedures for the Treatment of Gastroesopha-geal Reflux Disease (GERD) & Dysphagia
Adjunctive Techniques for Screening & Surveillance of Barrett’s Esophagus & Esophageal Dysplasia
Doppler-guided Transanal Hemorrhoidal Dearterialization
Anthem
Cigna
FloridaBlue
FloridaBlue
Anthem
FloridaBlue
FloridaBlue
Transanal Radiofrequency Treatment of Fecal Incontinence
Anthem
Fecal Analysis in the Diagnosis of Intestinal Dysbiosis

Ingestible pH & Pressure Capsule

FloridaBlue
FloridaBlue

91110, 91111, 0355T, 45378, 45380, 43191, 43193, 43197, 43198, 43200, 43202, 43235, 43239, 43647, 43648, 43881, 43882, 64590, 43631, 43632, 43633, 43634, 43644, 43645, 43770, 43771, 43772, 43773, 43774, 43775, 43842, 43843, 43845, 43846, 43847, 43848, 43886, 43887, 43888, 0312T, 0313T, 0314T, 0315T, 0316T, 0317T,

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