CPT 91125: Anorectal Manometry and Rectal Function Testing
CPT code 91125 represents anorectal manometry, a diagnostic physiologic test that assesses anal sphincter and rectal muscle pressures and coordination, often combined with rectal sensation testing and a balloon expulsion test. This test is clinically important for evaluating patients with chronic constipation, fecal incontinence, evacuation disorders, and other anorectal dysfunctions. Nationally, accurate coding for 91125 supports appropriate clinical management pathways and claims processing for specialty gastroenterology and motility services.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical context, service and site-of-care considerations, and commonly referenced related services. The publication highlights benchmarks and reimbursement context where available, typical clinical indications tied to the procedure, and policy elements that influence coverage and documentation expectations. Practical details address operational settings such as outpatient gastroenterology clinics and motility laboratories, helping clinical administrators and billing staff align coding with service delivery. Data not available in the input is noted where applicable.
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Billing Code Overview
CPT code 91125 describes anorectal manometry testing, a physiological assessment that measures anal sphincter and rectal muscle pressures during rest, voluntary squeeze, and simulated defecation. The procedure may include rectal sensation testing and a balloon expulsion test as part of a combined evaluation of anorectal function.
Service type: Diagnostic physiologic testing of anorectal function
Typical site of service: Outpatient gastroenterology clinic, motility laboratory, or ambulatory surgical/diagnostic center