Gastrointestinal (GI) Motility Measurement

This policy addresses gastrointestinal motility measurement procedures — including gastric emptying scintigraphy, radiopaque marker and colonic transit scintigraphy, colonic and anorectal manometry, and ingestible pH/pressure capsules — for evaluation of suspected gastroparesis, chronic constipation (to differentiate slow‑transit from pelvic floor or normal‑transit dysfunction), other motility disorders, and specifically colon manometry to guide surgical decision‑making in children with refractory colonic motility/defecatory disorders. Major limitations: coverage is restricted (colon manometry is primarily supported only for the pediatric surgical‑guidance indication), several modalities (ingestible pH/pressure capsules and cutaneous electrogastrography systems such as Gastric Alimetry/G‑Tech) are considered experimental/investigational, and this policy version is inactive and not for current claims adjudication.

"Colon manometric testing to guide surgical decision-making in children (<18 years) with refractory colonic motility or defecatory disorders."