Wireless Gastrointestinal Motility Monitoring Systems

The Wireless Motility Capsule (SmartPill) is covered when used by a trained gastroenterologist to evaluate suspected gastroparesis or to assess colonic transit in chronic idiopathic constipation (>6 months), and when basic clinical investigations including endoscopy have failed to establish a diagnosis. It is contraindicated in patients with gastric bezoar, swallowing disorders, GI strictures/fistulae, physiologic obstruction, recent GI surgery (<3 months), Crohn’s disease, diverticulitis, or implanted electromechanical devices, and is not covered for children (not FDA‑approved). Documentation must show prior nondiagnostic basic testing, discontinuation of medications affecting GI motility, and that a trained gastroenterologist ordered/interpreted the study.

"Coverage when used to evaluate patients with suspected delayed gastric emptying or gastroparesis of any etiology."