Upper Endoscopy for Gastroesophogeal Reflux Disease (GERD) and Gastrointestinal Symptoms
Upper endoscopy is a diagnostic procedure. Upper endoscopy involves the insertion of a thin flexible tube down a patient's throat and esophagus. The endoscope has a light and camera attached allowing a doctor to visually inspect the esophagus for abnormalities and to take small pieces of tissue (biopsy) if needed.
Coverage decision: Covered with conditions (Effective date: May 1, 2014).
Note: Upper endoscopy may be used only for care of a condition accepted on the claim. Upper endoscopy is an invasive procedure. GERD and GI symptoms are unlikely to be related to any occupational injury or disease and are therefore not expected to be accepted conditions on an L&I claim.
Authorization requirements
Is authorization required? |
How do I get pre-authorization? |
Yes |
L&I (State fund): Complete the Preauthorization Form and fax to (360) 902-4567 For self-insured: Contact the employer or its third party administrator |
Regulatory authority and related information
- Health Technology Clinical Committee (HTCC). RCW 70.14.080 through 70.14.130
- Health Technology Assessment Program
