Gastric Pacing/Gastric Electrical Stimulation (GES) - (0103)

Permanent GES (e.g., Enterra) is covered only under the FDA Humanitarian Device Exemption for chronic, intractable (drug‑refractory) nausea and vomiting secondary to diabetic or idiopathic gastroparesis; temporary GES and all other indications (including obesity, T2DM, other etiologies) are excluded. Coverage requires documentation of the HDE‑consistent indication (typically adults 18–70), prior failure/contraindication/intolerance of prokinetic/antiemetic therapy, exclusion of mechanical obstruction, operative/device documentation, and use of the specified CPT/HCPCS codes.

"Permanent gastric electrical stimulation (GES) or gastric pacing (e."

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