Esophageal and Airway pH Monitoring

Aetna covers esophageal pH monitoring for: refractory reflux-related chest pain after cardiac evaluation using a symptom‑reflux association (preferably symptom association probability) following ≥4 weeks of PPI; documenting abnormal acid exposure in endoscopy‑negative patients prior to anti‑reflux surgery after withholding antisecretory drugs >1 week; documenting GERD in adult‑onset non‑allergic asthma suspected of reflux‑induced asthma after withholding antisecretory drugs >1 week (positive test does not prove causality); evaluating otolaryngologic GERD symptoms after ≥4 weeks of PPI therapy (testing done while continuing therapy to document adequacy); and evaluating vomiting in infants ≤3 months. The Bravo disposable capsule is investigational/not covered for infant vomiting, multichannel intraluminal impedance and airway/pharyngeal pH monitoring are considered experimental/investigational (not covered) for other indications, and esophageal pH recording is investigational/not covered for other listed uses (e.g., diagnosing reflux esophagitis, alkaline reflux, identifying eosinophilic esophagitis in select children, or titrating PPI in Barrett’s).