Gastrointestinal Motility Disorders, Diagnosis and Treatment (for Ohio Only) – Community Plan Medical Policyopen_in_new
State-specific UnitedHealthcare medical policy for diagnostic procedures used in gastrointestinal motility and anorectal disorders in Ohio, describing which procedures are considered unproven/not medically necessary, definitions, evidence summaries, professional guideline positions, and applicable CPT/HCPCS/unlisted codes. This is part 1 of 2 and covers rationale, definitions, descriptions of services, evidence reviews for FLIP, MRI defecography, and electrogastrography/BSGM.
Title changed and Coverage Rationale language removed/relocated regarding gastric electrical stimulation (GES) therapy.
Removed reference to Ohio Administrative Code Rule 5160-10-01 (DMEPOS general provisions).
Revised list of unproven and not medically necessary procedures: added 'FLIP technology for diagnosing Achalasia'.
Removed listed examples of cutaneous/mucous/serosal EGG/BSGM device examples and MiVu mucosal integrity testing system from that list.
Removed content addressing coverage limitations and exclusions.
Added definitions for Achalasia and Functional Lumen Imaging Probe (FLIP).
Removed CPT codes 43647, 43648, 43881, 43882, 64590, and 64595 from Applicable Codes.
Updated Description of Services, Clinical Evidence, FDA, and References sections to reflect current information.
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