CPT® Code 91020

1. Indications

Gastric motility (manometric) studies are indicated for a variety of gastrointestinal symptoms and conditions that may suggest abnormal motor function of the stomach or duodenum. These indications include:

• Suspected Gastroparesis - A condition characterized by delayed gastric emptying, which can lead to symptoms such as nausea, vomiting, and bloating.
• Chronic Nausea and Vomiting - Persistent nausea and vomiting that cannot be attributed to other causes may warrant evaluation of gastric motility.
• Abdominal Pain - Unexplained abdominal pain that may be related to motility disorders can be assessed through these studies.
• Postprandial Symptoms - Symptoms occurring after meals, such as fullness, discomfort, or pain, may indicate motility issues.
• Evaluation of Functional Dyspepsia - Patients with functional dyspepsia, which includes symptoms of indigestion without an identifiable cause, may benefit from motility assessment.

2. Procedure

The gastric motility (manometric) study involves several key procedural steps to ensure accurate measurement and assessment of gastric function. These steps include:

• Step 1: Catheter Insertion - A specialized catheter, equipped with perfusion ports and/or transducers, is carefully inserted through the patient's nose or mouth and advanced into the stomach or duodenum. This step is crucial for obtaining accurate pressure readings from within the gastrointestinal tract.
• Step 2: Connection to Equipment - Once the catheter is in place, it is connected to a pump that will deliver water through the perfusion ports. The pump is also linked to a computer system that will record the pressure changes during the study.
• Step 3: Water Infusion - The pump begins to slowly infuse water into the stomach through the catheter. This infusion helps to stimulate gastric activity and allows for the measurement of intraluminal pressure changes as the stomach responds to the added volume.
• Step 4: Meal Administration (if applicable) - In some cases, the patient may be given a meal while the catheter remains in place. This step is important for assessing how the stomach and duodenum respond to food intake, as it provides additional data on motility and pressure changes during digestion.
• Step 5: Data Recording and Analysis - Throughout the procedure, the manometer continuously measures and records changes in intraluminal pressure. After the study is completed, the collected data is analyzed by the physician, who will interpret the results and prepare a written report of findings.

3. Post-Procedure

After the gastric motility (manometric) study is completed, the patient may experience some temporary discomfort due to the catheter placement. It is important for the healthcare provider to monitor the patient for any immediate adverse reactions. Patients are typically advised to resume normal activities as tolerated, but they may be instructed to avoid certain foods or activities for a short period following the procedure. The physician will review the findings with the patient during a follow-up appointment, discussing any necessary next steps based on the results of the study. A written report detailing the findings will also be provided to the referring physician for further evaluation and management of the patient's condition.