Lower Esophageal Magnetic Sphincter Augmentation
L39780
Magnetic sphincter augmentation is covered for patients with GERD confirmed by pH testing (AET > 6%), who have persistent symptoms despite at least 6 months of maximal PPI therapy, and who have undergone appropriate endoscopy and esophageal manometry; the procedure must be performed by a surgically experienced, product-trained operator. Coverage is excluded for a defined set of contraindications including relevant metal allergies, electrical or metallic abdominal implants, unrepaired large hiatal or paraesophageal hernias, Barrett's esophagus or LA class C/D esophagitis, significant motility disorders (distal peristaltic amplitude <35 mmHg), recent or frequent dysphagia, prior foregut surgery or endoscopic interventions, pregnancy/lactation or planned pregnancy, morbid obesity (BMI >35), neoplasia, varices, scleroderma, and anatomic esophageal abnormalities.
"Documented GERD based on abnormal ambulatory pH testing with acid exposure time (AET) > 6%."