US · guidance
NCD 100.4
Esophageal Manometry
Item/Service Description
The major use of esophageal manometry is to measure pressure within the esophagus to assist in the diagnosis of esophageal pathology including aperistalsis, spasm, achalasia, esophagitis, esophageal ulcer, esophageal congenital webs, diverticuli, scleroderma, hiatus hernia, congenital cysts, benign and malignant tumors, hypermobility, hypomobility, and extrinsic lesions. Esophageal manometry is mostly used in difficult diagnostic cases and as an adjunct to X- rays and direct visualization of the esophagus (endoscopy) through the fiberscope.
Indications and Limitations of Coverage
Esophageal manometry is covered under Medicare where it is determined to be reasonable and necessary for the individual patient.
History
Version 1
Provenance
- Source
- cms.gov
- Retrieved
- 2026-08-26
- Edition
- mcd-2026-08-26
- Content hash
43d0e7a4f6c27a7320fb9a8a04fb34e851b6abaea34b1e7062ac05df84427e78
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