The National Institute for Health and Care Excellence (NICE) has issued full guidance to the NHS in England, Wales, Scotland and Northern Ireland on endoscopic radiofrequency ablation for gastro-oesophageal reflux disease.

This guidance updates replaces NICE interventional procedure 292 (March 2009).


Gastro-oesophageal reflux disease (GORD) is a common problem and is caused by a variety of conditions that disturb the sphincter function at the lower end of the oesophagus, such as hiatus hernia. Symptoms of GORD can be broadly grouped into those directly related to reflux episodes, such as heartburn, regurgitation, chest pain and nausea and those symptoms caused by complications of reflux disease, including dysphagia, respiratory difficulties, Barrett's oesophagus or oesophageal stricture.

Lifestyle modification and drug therapy are the standard treatments for patients with symptomatic GORD. Drug therapy includes antacids, alginates and acid-lowering agents such as H2-receptor antagonists and proton pump inhibitors (PPIs). Patients who have refractory symptoms, who develop complications despite medication or who develop intolerance to medication, may be considered for anti-reflux surgery (usually laparoscopic fundoplication). Fundoplication involves wrapping the uppermost part of the stomach around the distal oesophagus, by an open or laparoscopic approach. A number of alternative endoscopic techniques have also been used.

Coding recommendations

G44.8 Other specified other therapeutic fibreoptic endoscopic operations on upper gastrointestinal tract

Y11.4 Radiofrequency controlled thermal destruction of organ NOC

Includes: Radiofrequency ablation of organ NOC

O11.1 Gastro-oesophageal junction

In addition an ICD-10 code from category K21.- Gastro-oesophageal reflux disease is assigned.

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