VHI

OGD clinical indicators

Surveillance

Code Letter Desc
780 z Barrett's mucosa (columnar-lined oesophagus) of less than 3 cms without dysplasia on previous endoscopy: Repeat endoscopy every 3 years
812 za Barrett's mucosa (columnar-lined oesophagus) of greater than 3 cms without dysplasia on previous endoscopy: Repeat endoscopy every 2 years
813 zb Barrett's mucosa (columnar-lined oesophagus) with low-grade dysplasia on previous endoscopy: Repeat endoscopy every 6 months until 2 consecutive endoscopies with no dysplasia.
814 zc Barrett's mucosa (columnar-lined oesophagus) with high-grade dysplasia on previous endoscopy: Repeat endoscopy every 3 months
930 zcc Surveillance post endoscopic treatment (RFA/EMA) of Barrett's oesophagus – Benefit allowed every 3 months
815 zd Gastric intestinal metaplasia/atrophic gastritis with no dysplasia: Repeat endoscopy every 3 years
816 ze Gastric intestinal metaplasia/gastric epithelial dysplasia/atrophic gastritis with low-grade dysplasia: Repeat endoscopy at 12 months
817 zf Gastric intestinal metaplasia/gastric epithelial dysplasia/atrophic gastritis with high-grade dysplasia: Repeat endoscopy at 6 months
818 zg Familial adenomatous polyposis (FAP): OGD every 2 years starting at age 18 years
819 zh Peutz-Jeghers syndrome: OGD every 2 years starting at age 18 years
820 zi Juvenile polyposis: OGD every 3 years starting at age 18 years
821 zj Lynch Syndrome: OGD every 2 years starting at age 50 years
822 zk MUTYH-associated polyposis (MAP): OGD every 3 years starting at age 30 years