Making Prevention Possible

Innovative proprietary preemptive screening technologies from CDx help improve patient outcomes and reduce healthcare costs for payers.








Each year, esophageal cancer kills more Americans than cervical cancer and melanoma combined. 

Esophageal Adenocarcinoma (EAC) is one of the most fatal and fastest-growing cancers. 

“By 2025, the prevalence of esophageal adenocarcinoma is expected to increase by 140%.”*

*Ruberstein JH Risk Factors for Barrett’s esophagus. Curr Opin Gatrone

While chronic heartburn (or GERD) is the most common risk factor for developing Barrett’s esophagus, other at-risk groups include:

  • Males

  • Obese patients

  • Tobacco users

  • Those >50 years of age

The cost to payers for screening and surveillance of Barrett's esophagus continues to increase yearly. Yet, the 5-year survival of esophageal adenocarcinoma remains miserable, in part, due to the limitations of the Seattle protocol.


WATS3D has become the standard of care when used adjunctively to the Seattle protocol.

The Seattle random forceps biopsy protocol does not reliably detect Barrett’s esophagus or dysplasia, which are precursors to esophageal adenocarcinoma. 


WATS3D is the Solution

WATS3D (Wide-Area Transepithelial Tissue Sampling with computer-assisted 3D analysis), when used as an adjunct to standard biopsy sampling,  has been shown to reliably detect unhealthy cells before they develop into cancer.

WATS3D is endorsed for both screening and surveillance of patients with suspected or known Barrett's esophagus , as an adjunct to routine biopsies, in  the recently published Guidelines of the American Society for Gastrointestinal Endoscopy (ASGE).

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Aligned with professional guidelines.*


ASGE Recommendation: 

 “In patients with known or suspected BE, we suggest using WATS3D in addition to WLE with Seattle protocol biopsy sampling compared with WLE with Seattle protocol biopsy sampling alone”

*ASGE guideline on Barrett’s (GI Endosc 90(3) 2019 page 351)

Why Payers Support WATS3D

enhanced patients outcomes icom

Enhanced Patient Outcomes

Early detection of dysplasia enables physicians to treat patients with ablation therapy and prevent the development of esophageal carcinoma.


Improved Population Health

More than half of the US population is now over the age of 50,an age that is at risk for esophageal adenocarcinoma.  Detecting dysplasia early and treating it has the potential to greatly reduce the incidence of this deadly disease.



According to the NIH data, the US is projected to spend approximately $2.97B on the diagnosis and treatment of esophageal adenocarcinomas by 2020. The vast majority of this expense is tied to esophagectomy and treatment.

WATS3D when used adjunctively to standard forceps biopsy, is more cost-effective for Barrett's esophagus screening compared to forceps biopsy alone.

Singer ME. Gross S, Kaul V, Smith MS. Cost-Effectiveness of Adjunctive Wide Area Transepithelial Sampling With Computer-Assisted Analysis in Screening for Barrett's Esophagus: 449. American Journal of Gastroenterology: 2019;114:S262

CPT Coding

The following table shows typical billing codes used for WATS3D procedures.

CPT Code CPT Descriptor Maximum Daily Units
88104 Cytopathology, fluids, washings or brushing, except cervical or vaginal 1
88305 Surgical pathology, gross and microscopic examination 1
88312 Special stain including interpretation and report 1
88361 Morphimetric analysis, tumor immunohistochemistry (e.g., Her2nue, estrogen receptor/progesterone receptor), quantitative or semi-quantitative, each antibody, using computer-assisted technology 4


*One kit for each 5cm of at-risk mucosa.



Clinical Studies on the Adjunct Use of WATS3D


# of Patients:

Study Design:

Study Population:

Main Results:

Smith et al.

Dis of the Esophagus (2018)




Community Based

⇪Barrett’s   153%

⇪Dysplasia  242%

Gross et al.

United European Gastroenterol J (2018)



Community Based

⇪Barrett’s 83%

⇪Dysplasia 89%

Vennalaganti et al.

Gastrointest Endosc (2018)


16 Med Centers



Academic Centers

(High Risk)

⇪High-Grade Dysplasia  428%

Anandasabapathy et al.

Dig Dis Sci (2011)



Academic Centers

⇪Dysplasia 42%

Johanson et al.

Dig Dis Sci (2011)




Community Based

⇪Barrett’s 70.5%

⇪Dysplasia 87.5%



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See how WATS3D technology improves patient outcomes.

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