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Billing and Coding: Pelvic Floor Dysfunction: Anorectal Manometry and EMG
A57595
Wisconsin Physicians Service Insurance Corporation (J05)
Effective: October 1, 2025
Updated: December 31, 2025
Policy Summary
Anorectal manometry and pelvic floor EMG are covered as diagnostic tests for anorectal or pelvic floor dysfunction when supported by documentation of medical necessity per the related LCD. They are not appropriate for evaluation of urinary incontinence alone, are not considered part of routine therapy programs (PT/rehab/biofeedback/exercise), and Medicare does not expect these tests to be billed more than twice in a lifetime.
Coverage Criteria Preview
Key requirements from the full policy
"Anorectal manometry and pelvic floor electromyography (EMG) are indicated as diagnostic tests for evaluation of anorectal or pelvic floor dysfunction (e."
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